A health system wide approach to the delivery of survivorship care plans.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 42-42
Author(s):  
Jennifer R. Klemp ◽  
Heather Vanbebber ◽  
Tanya Folker ◽  
Lisa Serig ◽  
Tim Metcalf ◽  
...  
Keyword(s):  
Health System ◽  
Medical Center ◽  
Academic Medical Center ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Clinical Patient ◽  
Care Plans ◽  
Accreditation Standards ◽  
Patient Reported

42 Background: Survivorship care plans (SCPs) are recognized by organizations including the American Society of Clinical Oncology and the American College of Surgeons Commission on Cancer, as a best practice for improving survivor care. Little evidence supports this and hospitals and cancer centers are scrambling to meet deadlines for SCP development and delivery. The University of Kansas Cancer Center (KUCC) addressed this utilizing electronic health record (EHR) integration, developing a health system wide approach to education and delivery, and building referral workflows to primary care and specialists. We report on this approach to developing and growing a survivorship care program. Methods: KUCC is a NCI designated cancer center within an academic medical center and health system, with 11 outpatient locations across the Kansas City. Under the guidance of a multidisciplinary team: providers, health care informatics, administrators, nursing, tumor registry, quality improvement, and researchers, KUCC developed a step-wise process to deliver comprehensive survivorship care across the health system. This multi-year initiative aligned with institutional accreditation standards and an ongoing focus on expanding evidence based, comprehensive cancer and supportive care. Results: In 2014 a formal survivorship program plan was put into action: Support from leadership, providers, research priority; Staff and patient survivorship education & training; Integrated delivery of survivorship care at all locations with direct interaction and feedback from cancer care teams; Short & long-term programmatic goals; Management and referral of late effects of cancer; EPIC integrated SCP template: auto-populated, customized, personalized; treatment summary uses tools that pull in data stored discreetly in the patient "file"; SCP delivery targeting COC phase-in timeline: 2015: n= 539 (10% projection n= 434); 2016: n= 1,355 (25% projection n=1,253). Conclusions: This step-wise, integrated approach to survivorship care has resulted in a health system wide delivery of SCPs and meeting national accreditation standards. Next steps include the evaluation of cost and clinical/patient reported outcomes.

Who is receiving survivorship care plans? Findings from the 2012 Livestrong survey.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9608-9608
Author(s):  
Ruth Rechis ◽  
Carla Bann ◽  
Stephanie Nutt ◽  
Linda Squiers ◽  
Naveen Rao
Keyword(s):  
Medical Center ◽  
Care Plan ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Long Term Effects ◽  
Care Plans ◽  
Key Stakeholders

9608 Background: There are more than 14 million cancer survivors in the US – a number that is on the rise. Care coordination resources will be essential to provide support to this growing population. Key stakeholders, including the Commission on Cancer (CoC) and the Institute of Medicine, have proposed survivorship care plans (SCPs) as a way to extend support. However, limited research has been conducted to date on SCPs. Methods: In 2012, the LIVESTRONG Foundation (LIVESTRONG) administered a survey to understand the role of a treatment summary (TS) and SCPs and how they fit into survivors’ care. Logistic regression models were conducted to identify factors associated with receiving SCPs or TS. Results: 5,303 survivors responded to these questions (Table). While 92% of these respondents received information about where to return to for cancer check-ups, only 51% reported receiving a TS and 17% reported receiving a SCP. Survivors who were more likely to receive SCPs if they had a navigator (p<.001) and if they were male, Black, had finished treatment within the past year, or received care at a university-based medical center or community cancer center (p < 0.05). Also, those receiving a SCP were significantly more likely to have had a detailed discussion with a provider regarding long-term side effects, emotional needs, and lifestyle recommendations. Specifically, 60% of those with a SCP discussed long-term effects compared to 39% who did not. Conclusions: Results here indicate that few survivors receive SCPs but survivors reported benefits from receiving them. Currently many workflow barriers impede delivering SCPs, and LIVESTRONG is working with key stakeholders including the CoC to automate the LIVESTRONG Care Plan powered by Penn Medicine’s OncoLink through a registry and EMR system to understand how to address this issue. [Table: see text]

scholarly journals Use of Survivorship Care Plans and Analysis of Patient-Reported Outcomes in Multinational Patients With Lung Cancer

2016 ◽  
Vol 12 (5) ◽  
pp. e527-e535 ◽  
Author(s):  
Abigail T. Berman ◽  
Cristina M. DeCesaris ◽  
Charles B. Simone ◽  
Carolyn Vachani ◽  
Gloria DiLullo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Patient Reported Outcomes ◽  
Primary Lung Cancer ◽  
The United States ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Cognitive Changes ◽  
Care Plans ◽  
Patient Reported

Purpose: Lung cancer is the leading cause of cancer death and is a significant source of morbidity. Patient-reported outcomes (PROs) have been shown to be prognostic for survival. We have analyzed emerging patterns of longitudinal PROs collected in the development of survivorship care plans (SCPs). Methods: OncoLife and the LIVESTRONG Care Plans are Internet-based programs designed to generate unique SCPs. We selected SCPs from patients identifying as survivors of primary lung cancer. Patient-reported demographics and treatment and toxicity data were examined. Effects were categorized by the physiologic system that they affected. Results: Six hundred eighty-nine plans were created for users self-identifying as survivors of primary lung cancer. Average time from diagnosis to reporting was 1.68 years (range, 0 to 24 years). Most were white (85.9%), well educated (61.1% “some college” or higher), and lived in the United States (90.7%). Patients underwent chemotherapy (75.8%), radiotherapy (54.7%), and surgery (54.4%). Neurocognitive symptoms (eg, fatigue, cognitive changes) were the most common (48.8%), especially among those receiving chemotherapy, followed by musculoskeletal/dermatologic symptoms (14.1%) and thoracic symptoms (13.5%). Only 11.2% were initially offered an SCP. Of those offered SCPs, 54.5% were offered by their health care provider, and most often were at a non–university-based cancer center (66.2%). Conclusion: For patients with lung cancer worldwide, it is feasible to obtain PROs and to create SCPs through an Internet-based program. As patients with lung cancer achieve improved survival, further attention should be paid to PROs. Surprisingly, neurocognitive symptoms seem to be the most common issues and therefore the most important to address. Increased effort should be made to provide SCPs, particularly in urban and university cancer center settings.

Challenges in the implementation of survivorship care plans in an NCI-designated cancer center.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 68-68 ◽  
Author(s):  
Mary Mendelsohn ◽  
Joanne E. Mortimer ◽  
Leslie Popplewell ◽  
Lily L. Lai ◽  
Ellie Maghami ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Coordinator ◽  
Nurse Care ◽  
Care Plans ◽  
Patient Reported

68 Background: The development and initiation of Survivorship Care Plans (SCPs) across all disease sites was identified as a Strategic Initiative Goals for 2015 by the Clinical Cancer Committee. The 2012 Commission on Cancer requirements for certification provided an additional incentive to meet this goal. Establishing a process that includes the development and distribution of a SCP’s within the electronic medical record (EMR) is necessary to improve on the completion of SCP’s and to improve the utilization of surveillance tests in cancer survivors. We describe the process developed at a free-standing NCI cancer center to meet the standard of SCP provision to all cancer patients. Methods: A multi-disciplinary subcommittee of the Cancer Committee was designated to develop the overall strategic plan for the implementation of this standard. It met with disease teams to facilitate a treatment summary from Cancer Registry data, identify patient reported symptoms using a self report tablet (SupportScreen). Electronic care plans were created using survivorship research program templates and ASCO framework for each disease site team. The disease team Nurse Care Coordinator inputs information into the eSCP. Results: Templates have been established within the EMR in the documents section under survivorship care plan title. These can be initiated and modified when the Nurse Care Coordinator chooses to start them. The disease teams have established their time points for SCP presentation to their patients. Using the cancer registry to provide data related to staging, treatments and genetic testing has helped minimize development time. Individual survivor’s concerns will be reflected in patient reports and physician symptom documentation. This eSCP completion process is a pilot program within the breast cancer disease team and will be expanded to include patients with head & neck and hematologic malignancies with a goal of including all patients by mid 2016. Conclusions: The goal of improving survivorship care coordination and compliance with surveillance guidelines is challenging. Maximizing available interdisciplinary resources has helped to create a viable Survivorship Care plan at our institution.

Who is receiving survivorship care plans? Findings from the 2012 LIVESTRONG survey.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 26-26
Author(s):  
Ruth Rechis ◽  
Stephanie Nutt ◽  
Carla Bann ◽  
Linda Squiers ◽  
Naveen Rao
Keyword(s):  
Medical Center ◽  
Care Plan ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Long Term Effects ◽  
Care Plans ◽  
Key Stakeholders

26 Background: There are more than 14 million cancer survivors in the US – a number that is on the rise. Care coordination resources will be essential to provide support to this growing population. Key stakeholders, including the Commission on Cancer (CoC) and the Institute of Medicine, have proposed survivorship care plans (SCPs) as a way to extend support. However, limited research has been conducted to date on SCPs. Methods: In 2012, the LIVESTRONG Foundation (LIVESTRONG) administered a survey to understand the role of a treatment summary (TS) and SCPs and how they fit into survivors’ care. Logistic regression models were conducted to identify factors associated with receiving SCPs or TS. Results: 5,303 survivors responded to these questions. While 92% of these respondents received information about where to return to for cancer check-ups, only 51% reported receiving a TS and 17% reported receiving a SCP. Survivors who were more likely to receive SCPs if they had a navigator (p<.001) and if they were male, black, had finished treatment within the past year, or received care at a university-based medical center or community cancer center (p < 0.05). Also, those receiving a SCP were significantly more likely to have had a detailed discussion with a provider regarding long-term side effects, emotional needs, and lifestyle recommendations. Specifically, 60% of those with a SCP discussed long-term effects compared to 39% who did not. Conclusions: Results here indicate that few survivors receive SCPs but survivors reported benefits from receiving them. Currently many workflow barriers impede delivering SCPs, and LIVESTRONG is working with key stakeholders including the CoC to automate the LIVESTRONG Care Plan powered by Penn Medicine’s OncoLink through a registry and EMR system to understand how to address this issue.

scholarly journals Practice, Preferences, and Practical Tips From Primary Care Physicians to Improve the Care of Cancer Survivors

2019 ◽  
Vol 15 (7) ◽  
pp. e600-e606 ◽  
Author(s):  
Allison L. McDonough ◽  
Julia Rabin ◽  
Nora Horick ◽  
Yvonne Lei ◽  
Garrett Chinn ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivorship ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
Medical Center ◽  
Academic Medical Center ◽  
Late Complications ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

PURPOSE: There is a need to improve the coordination of care and communication between primary care physicians (PCPs) and oncology after completion of initial cancer treatment. We sought to evaluate PCP experiences and perspectives in cancer survivorship and to identify practical opportunities to improve care within an integrated health care system with a shared electronic health record (EHR). METHODS: We conducted a self-administered, anonymous, electronic survey of PCPs in practices affiliated with an academic medical center to evaluate practices, the sense of preparedness, and preferences in the delivery of survivorship care and communication with oncology. RESULTS: One hundred seventeen of 225 PCPs responded (response rate, 52%). A majority were engaged in survivorship care, with 94% reporting managing psychological sequelae of cancer, 84% managing chronic physical complications, 71% screening for cancer recurrence, and 60% screening for late complications. However, few PCPs felt prepared to manage these issues: 65% felt unprepared to screen for late complications, and 36% felt unprepared to screen for recurrence. Common barriers to survivorship care were uncertainty about delegation of responsibility (73%) and a lack of training (72%). PCPs expressed strong interest in survivorship care plans, preferring active tracking of ongoing care needs and delegation of care responsibility in the EHR active problem list over traditional summary documents. CONCLUSION: Most PCPs are engaged in cancer survivorship care but report barriers to optimal care delivery. Opportunities to improve care could include targeted education to increase preparedness to deliver survivorship care, and optimization of communication among providers, including active survivorship care plans in the EHR.

Survivorship care plans: Implementation in an academic medical center.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 64-64
Author(s):  
Hien Le ◽  
Matthew M Cadorette ◽  
William M Decaneas ◽  
Irving D. Kaplan ◽  
Mary Jane Houliahn ◽  
...  
Keyword(s):  
Active Treatment ◽  
Medical Center ◽  
Academic Medical Center ◽  
Surgical Oncology ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Palliative Intent ◽  
Care Plans ◽  
Academic Medical

64 Background: There are more than 14 million cancer survivors in the US. The Commission on Cancer requires survivorship care plans (SCPs) for patients with Stages I-III cancer. We developed a centralized process to create and monitor SCPs at an academic medical center. Methods: Tumor registry (TR) and clinical decision support teams built an SCP report to identify patients with stage I-III malignancies diagnosed within the past year (18 months for breast cancer patients on hormonal therapy) with a future appointment with medical, radiation or surgical oncology. The TR runs this report to identify patients nine-months post-diagnosis and then e-mails providers a draft SCP two days prior to the appointment. The provider edits this SCP and creates a note linked to the problem list item “Cancer Survivorship,” which is captured as a field in the SCP report. The SCP is mailed to the PCP and handed to the patient. If the SCP is not completed, the TR will send a reminder to the clinician. Results: From September to October 2017, 77 potential cases were reviewed by the TR and 25 (32%) were excluded because of active treatment (9), treatment with palliative intent (5), recurrence (8), and treatment by an outside provider (1). Of the 53 SCP’s e-mailed to providers, 12 were completed and 11 were excluded for active treatment (3), treatment with palliative intent (1), recurrence (3), missed/cancelled appointment (2), SCP sent to provider not providing treatment (1) and inability to discuss SCP with patient (1). An additional five had SCPs completed but were not in the electronic medical record. The overall completion rate of SCPs on eligible patients was 17/42 (40%). SCPs were completed in melanoma, breast, stomach, colon, and prostate cancers by medical, surgical, and radiation oncologists. Conclusions: At an academic medical center, we centrally implemented SCPs across a variety of disease types by a variety of providers. SCPs were completed without the need for additional visits, providers or workspace. Screening patients for eligibility before sending SCPs was vital as many were ineligible. Resources including 20% of a tumor registrar’s time, disease-group level buy-in and leadership support were vital.

Use of online survivorship care plans by young adult cancer survivors: Patient characteristics and patient reported outcomes.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 55-55
Author(s):  
Dava Szalda ◽  
Marilyn M. Schapira ◽  
Linda A. Jacobs ◽  
Carolyn Vachani ◽  
James M. Metz ◽  
...  
Keyword(s):  
Young Adult ◽  
Side Effects ◽  
Patient Reported Outcomes ◽  
Adult Survivors ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans ◽  
Adult Cancer Survivors ◽  
Patient Reported

55 Background: Young adult survivors (YAS) are at risk for side effects of cancer therapy and poor post treatment self-management relative to older adult survivors (AS). Survivorship care plans (SCPs) have proved feasible to provide education on symptom management, but the characteristics of YAS who utilize SCPs and patient-reported outcomes (PROs) of YAS via SCPs remains unstudied. Methods: Patient-reported characteristics and outcomes of YAS, age 18 to 39 years, who used a free online SCP generator (OncoLife), between May 2010 and May 2012 are reported. PROs of YAS were compared to AS, age 40-70 years, via frequencies and chi-squared analyses. PROs were queried upon generation of SCP based on diagnosis and treatments received. Results: YAS (n = 1,445, Mage= 31.5 years) and AS (n = 6301, Mage= 56.3 years) were primarily female (69% vs. 78%), Caucasian (76% vs. 86%) and an average of 2.6 years (range 0-20years) vs. 3.2 years (range 0-46 years) since diagnosis and treatment. Most common diagnoses were breast cancer, testicular cancer, lymphoma, thyroid cancer, and sarcomas in YAS vs. breast, colon, lymphoma, prostate, and lung cancer in AS. Three-quarters (75%) of YAS and 70% of AS generated the SCP themselves with the remaining SCPs generated by health care providers. Less than a quarter (22%) of YAS or AS (18%) reported previously receiving a treatment summary. The most commonly endorsed PROs in YAS and AS were neurocognitive changes and fatigue. Fewer YAS than AS endorsed pulmonary concerns and male sexual side effects. The majority of PROs were reported at similar proportions by YAS and AS (see table). Conclusions: In patients who generated an OncoLife SCP, YAS reported similar rates of treatment-related side effects to those reported by AS demonstrating SCPs as a mechanism to capture and address off-therapy issues for all survivors. [Table: see text]

Survivorship care plans: Processes, effective strategies, and challenges in a rural state.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 47-47 ◽  
Author(s):  
Mary Isaacson ◽  
Polly Hulme ◽  
Jenna Cowan ◽  
Jennifer Kerkvliet ◽  
Mary Minton ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Cancer Survivorship ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Open Communication ◽  
Effective Strategies ◽  
Care Plans ◽  
Process Framework ◽  
Rural State

47 Background: Annually, South Dakota (SD) averages nearly 4,000 new cancer cases with over 40,000 cancer survivors residing in the state. While the cancer incidence and survivorship rates in SD may be similar to the rest of the nation, SD’s unique geographic and demographic landscape offers challenges in cancer survivorship care. The purpose of this presentation is to illustrate the development and implementation of cancer survivorship care plans (SCP) at three health systems in the rural state of SD. Each of these health systems is unique in its history, culture, and infrastructure. Collectively, they serve most cancer patients living in SD. Methods: An observational qualitative design was used. Key players at each health system were interviewed using a structured interview. The interviews were audio-recorded and transcribed. The authors synthesized the transcriptions with member-checking completed for each system. Results: Processes for development and implementation of SCPs similar across health systems were (a) gathering a leadership team or making a designated staff role for survivorship care, (b) developing a SCP template(s), (c) provider/staff in-put and endorsement, and (d) tracking and identifying patients for scheduling and receipt. On the other hand, the health systems approached SCP completion and delivery differently. For example, at one health system multiple individuals from the patient’s care team were responsible for SCP population and completion. Effective strategies across health systems comprised incorporating prior SCP work, open communication, and standardization of SCPs with flexibility in implementation. Challenges included incompatibilities of electronic health record platforms for automatic SCP template population and adequate staffing for the complexities of enacting SCPs. Key findings suggest a process framework is beneficial for the development and implementation of SCPs. Conclusions: As health systems consider developing and implementing SCPs, consideration of the following recommendations for a process framework may be helpful: building a foundation, gathering resources, reviewing the evidence, eliciting input, and implementing in stages.

Tailored survivorship care plans for head and neck cancer patients.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 51-51
Author(s):  
Andrew L. Salner ◽  
Shrujal S. Baxi ◽  
Elizabeth Fortier ◽  
Talya Salz
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Primary Care Providers ◽  
Cancer Surveillance ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans ◽  
Patient Reported

51 Background: Survivorship care plans SCPs typically include generic advice for cancer surveillance, management of late effects (LEs), wellness recommendations (WRs), and cancer screening. We developed a platform called HN-STAR that uses electronic patient-reported outcomes (ePROs) and evidence-based management guidelines to generate tailored SCPs for head and neck cancer survivors (HNCSs), a population particularly vulnerable to various LEs. We surveyed HNCSs and their primary care providers (PCPs) regarding the SCP to assess its acceptability and usefulness. Methods: HNCSs at 2 cancer hospitals used HN-STAR. Prior to a routine clinic visit, HNCSs used a validated ePRO measure (PRO-CTCAE) to report 22 physical LEs and other measures to assess wellness. Based on the visit discussion, HN-STAR generated an SCP that included a treatment summary, WRs, and LE management plans. HNCSs indicated their perceptions of the SCP and intentions to adhere to WR and LE management recommendations. PCPs reported on the SCP utility and their comfort in managing WRs and LEs. Results: 47 HNCSs completed surveys (mean 5.4 yrs. from treatment completion). Most were white (89%), male (85%), had an oropharynx tumor (58%), and received multimodality therapy (81%). 51% experienced at least 9 of the 22 LEs in the last month (mean 8.2/person). 91% of HNCSs felt the SCP was easy to follow. 98% intended to follow recommendations for LEs management and 98% reported they would refer back to the SCP. 87% said they plan to share the SCP with a PCP. 23 PCPs completed the survey. 95% were satisfied with the SCP and 95% reported they would like to have one for every cancer patient. PCPs expressed varying levels of comfort in managing specific LEs of head and neck cancer (30-80%). Conclusions: Among HNCSs, an automatically generated SCP that was tailored to their WRs and LEs was acceptable, was trusted, and provided recommendations they intended to follow. PCPs found the SCP useful, and SCPs may help improve their comfort with LE management. Patient-centered SCPs that focus on existing LEs hold promise as a means to help survivors and PCPs manage survivorship issues.

Variations in recommended surveillance in colorectal cancer survivorship care plans.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 13-13
Author(s):  
Alaina Chodoff ◽  
Katherine Clegg Smith ◽  
Aishwarya Shukla ◽  
Amanda L. Blackford ◽  
Nita Ahuja ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Risk ◽  
Controlled Trial ◽  
Center Frequency ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

13 Background: Survivorship care plans (SCPs) outline pertinent information about a cancer survivor’s treatment and follow-up care. We describe the content of colorectal cancer (CRC) SCPs, completed as part of a randomized controlled trial of SCPs, and evaluate whether follow-up recommendations are guideline concordant. Methods: We analyzed 74 CRC SCPs from an academic and community cancer center. Frequency distributions and descriptive statistics were calculated for the entire cohort and separately by recruiting site. Follow-up recommendations were compared to American Cancer Society (ACS), American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines (Table). Results: Content routinely provided in SCPs (>80%) included patient demographics, cancer diagnosis, treatment details (surgery, chemotherapy, radiation therapy) as well as treatment-related side effects. SCP content specified less frequently included cancer stage, cancer risk (predisposing conditions), and recommendations for genetic counseling/testing and health promotion. Nearly all SCPs from the community site provided uniform, guideline-concordant follow-up. At the academic site, on average, more than 15 follow-up recommendations were listed for each surveillance modality, except colonoscopy. Among the SCPs that specified the frequency of follow-up care, the rate of guideline-concordant recommendations was 15/42 (36%) for follow-up visits, 29/43 (67%) for imaging, 12/45 (27%) for laboratory and 39/39 (100%) for colonoscopy. Conclusions: SCPs consistently provided information about CRC diagnosis and treatment, but often omitted information about cancer risk, staging and prognosis. There was considerable variation between cancer centers in the follow-up recommendations suggested for CRC survivors. Future work to improve the consistency of SCP follow-up recommendations with guidelines may be needed. Clinical trial information: NCT03035773 . [Table: see text]

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