Abstract
Aims
Outcomes for patients with oesophago-gastric cancer are variable across Europe. The
reasons for this variability are not clear. The aim of this study was to describe
and analyse clinical pathways to understand differences in service provision for oesophageal
and gastric cancer in the countries participating in the EURECCA Upper GI group.
Methods
A questionnaire was devised to assess clinical presentation, diagnosis, staging, treatment,
pathology, follow-up and service frameworks across Europe for patients with oesophageal
and gastric cancer. The questionnaire was issued to experts from 14 countries. The
responses were analysed quantitatively and qualitatively and compared.
Results
The response rate was (10/14) 71.4%. The approach to diagnosis was similar. Most countries
established a diagnosis within 3 weeks of presentation. However, there were different
approaches to staging with variable use of endoscopic ultrasound reflecting availability.
There has been centralisation of treatments in most countries for oesophageal surgery.
The most consistent area was the approach to pathology. There were variations in access
to specialist nurse and dietitian support. Although most countries have multidisciplinary
teams, their composition and frequency of meetings varied. The two main areas of significant
difference were research and audit and overall service provision. Observations on
service framework indicated that limited resources restricted many of the services.
Conclusion
The principle approaches to diagnosis, treatment and pathology were similar. Factors
affecting the quality of patient experience were variable. This may reflect availability
of resources. Standard pathways of care may enhance both the quality of treatment
and patient experience.
Keywords
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Article Info
Publication History
Published online: February 05, 2016
Accepted:
January 2,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
