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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References
- Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE-5 – a population-based study.Lancet Oncol. 2014; 15: 23-34
- Variations among 5 European countries for curative treatment of resectable oesophageal and gastric cancer: a survey from the EURECCA Upper GI Group (European Registration of Cancer Care).Eur J Surg Oncol. 2016; 42: 116-122
- Role of clinical pathways in health care provision: focus on cancer treatment.Am J Health Syst Pharm. 2013; 70: 1081-1085
- Care pathways lead to better teamwork: results of a systematic review.Soc Sci Med. 2012; 75: 264-268
- Care pathways across the primary-hospital care continuum: using the multi-level framework in explaining care coordination.BMC Health Serv Res. 2013; 13: 296-308
- Common data items in seven European oesophagogastric cancer surgery registries: towards a European upper GI cancer audit (EURECCA Upper GI).Eur J Surg Oncol. 2014; 40: 325-329
- European Registration of Cancer Care. 2013 (Available from:)
- Guidelines for the management of oesophageal and gastric cancer.Gut. 2011; 60: 1449-1472
- Third international conference of the European Union Network of Excellence on gastric and esophagogastric junction cancer, Cologne, Germany, June 2012.Gastric Cancer. 2015; 18: 193-199
- Gastric cancer: ESMO-ESSO-ESTRO clinical practice guidelines for diagnosis, treatment and follow-up. European Society of Surgical Oncology (ESSO). European Society of Radiotherapy and Oncology (ESTRO).Eur J Surg Oncol. 2014; 40: 584-591
- Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2013; 24: 51-56
- Highlights of the EORTC St. Gallen International Expert Consensus on the primary therapy of gastric, gastroesophageal and oesophageal cancer – differential treatment strategies for subtypes of early gastroesophageal cancer.Eur J Cancer. 2012; 48: 2941-2953
- Unmet needs and challenges in gastric cancer: the way forward.Cancer Treat Rev. 2014; 40: 692-700
- The volume-outcome relation in the surgical treatment of esophageal cancer: a systematic review and meta-analysis.Cancer. 2012; 118: 1754-1763
- Re-organisation of oesophago-gastric cancer services in England and Wales: a follow-up assessment of progress and remaining challenges.BMC Res Notes. 2014; 7: 24-31
- Consensus guidelines for enhanced recovery after gastrectomy: enhanced recovery after surgery (ERAS®) Society recommendations.Br J Surg. 2014; 101: 1209-1229
- Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs.Cochrane Database Syst Rev. 2010; 3: CD006632
- Enforcing centralization for gastric cancer in Denmark.Eur J Surg Oncol. 2010; 361: 50-54
- Re-organisation of oesophago-gastric cancer care in England: progress and remaining challenges.BMC Health Serv Res. 2009; 9: 204-212
Article info
Publication history
Published online: February 05, 2016
Accepted:
January 2,
2016
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
