P-149 Management of rectal cancer in the Algerian west: A cohort of 164 patients treated at the department of radiation oncology of EHSO Emir Abdelkader of Oran

141 Background: The treatment of stage II/III rectal cancer is complex and requires multidisciplinary collaboration. Delays in definitive treatment may increase morbidity and compromise outcomes. The goal was to reduce the time from pathologic diagnosis to initiation of treatment by 30% for patients with stage II/III rectal cancer at Lyndon B. Johnson General Hospital (LBJGH), which provides care to uninsured and underinsured patients in Harris County, TX. Methods: The charts of 32 patients with rectal cancer diagnosed between July 2012 and December 2013 were reviewed. Baseline data regarding diagnostic and treatment time points were collected. Potential areas for improvement were identified through analysis of the baseline data, affinity sorting, and fishbone diagrams. A multidisciplinary rectal cancer working group with all relevant administrative and subspecialty stakeholders was created to discuss potential interventions and implementation strategies. The project was approved by the MD Anderson Quality Improvement Assessment Board. Results: Twenty-four of the thirty-two patients reviewed had stage II/III rectal cancer and were eligible for multimodality therapy with curative intent. The median time from pathologic diagnosis to treatment initiation was 62 days. The referral process was identified as the greatest source of delays. The median times from diagnosis to medical oncology and radiation oncology referral were 15 and 32 days, respectively. The median time for eligibility verification and clinical review by Case Management was 13 days. Conclusions: Based on these findings, two primary interventions have been instituted: (1) A synchronized referral process that will result in simultaneous consultation of all involved subspecialty services (surgery, medical oncology, and radiation oncology) was created for patients with rectal cancer; (2) Redundancy in the clinical review process was eliminated by coordination between Case Management and the Medical Oncology Chief Fellow. In tandem, these interventions are projected to reduce the time from diagnosis to treatment by approximately 50% (from 62 to 29 days).

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Modern Aspects of Radiation Oncology for Rectal Cancer

Rectal Cancer ◽

10.1007/88-470-0343-1_25 ◽

2006 ◽

pp. 221-225

Author(s):

Mario Romano ◽

Antonio B. Porcaro

Keyword(s):

Rectal Cancer ◽

Radiation Oncology

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Rectal Cancer

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2012.0158 ◽

2012 ◽

Vol 10 (12) ◽

pp. 1528-1564 ◽

Cited By ~ 108

Author(s):

Al B. Benson ◽

Tanios Bekaii-Saab ◽

Emily Chan ◽

Yi-Jen Chen ◽

Michael A. Choti ◽

...

Keyword(s):

Rectal Cancer ◽

Radiation Oncology ◽

Multidisciplinary Approach ◽

Clinical Presentation ◽

Medical Oncology ◽

Neoadjuvant Treatment ◽

Surgical Oncology ◽

Care Physician ◽

Pathologic Staging ◽

Localized Disease

These NCCN Clinical Practice Guidelines in Oncology provide recommendations for the management of rectal cancer, beginning with the clinical presentation of the patient to the primary care physician or gastroenterologist through diagnosis, pathologic staging, neoadjuvant treatment, surgical management, adjuvant treatment, surveillance, management of recurrent and metastatic disease, and survivorship. This discussion focuses on localized disease. The NCCN Rectal Cancer Panel believes that a multidisciplinary approach, including representation from gastroenterology, medical oncology, surgical oncology, radiation oncology, and radiology, is necessary for treating patients with rectal cancer.

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