Multidisciplinary Workflow Benefits Patients With Newly Diagnosed Pancreatic Cancer

Raj Vaghjiani, MD

Early experience with a newly designed pancreatic cancer multidisciplinary clinic workflow at Roswell Park Comprehensive Cancer Center in Buffalo, New York, showed significant improvement in terms of time to subspecialty evaluation, according to findings presented at the 2022 American Society of Clinical Oncology Quality Care Symposium.

In September 2021, patients who had recently received a diagnosis of pancreatic adenocarcinoma were stratified according to whether they preceded (n = 14) or followed (n = 30) the implementation of the new workflow. Investigators found that after a biopsy diagnosis of pancreatic adenocarcinoma, the time interval from initial surgical consultation to first medical oncology consultation was reduced from 7 days to 1 day (P = .003). In addition, after the workf low was established, more than 90% of patients were seen on the same day, compared with 7% before the workflow was established.

The new workflow was implemented at a single tertiary-care comprehensive cancer center. Patients who presented to the clinic underwent same-day consultations with surgical oncology, medical oncology, genetic counseling and testing, and nutritional counseling, among others (Figure¹).

Multidisciplinary Workflow at a Same-Day Clinic for Patients With Newly Diagnosed Pancreatic Cancer¹

Upon arrival, patients were assigned a cancer care coordinator. Their case was then presented to a multidisciplinary tumor board and later evaluated by surgical oncology, medical oncology, and other specialties. Patients underwent additional testing, procedures, and port placement as needed before therapy was initiated.

The average times to provider consultation, port placement, and initiation of neoadjuvant chemotherapy therapy were compared with the patient’s T-test.

The updated workflow did not result in a significant time difference from initial biopsy diagnosis to either surgical consultation or medical oncology consultation. Biopsy to port placement and biopsy to chemotherapy initiation times were likewise unaffected.

“This quality-improvement effort has already reduced patient burdens in accessing timely care,” Raj Vaghjiani, MD, a fellow in complex general surgical oncology in the Department of Surgical Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, New York, wrote in the poster. “Our continued efforts focus on further improving care coordination along the entire patient cancer care trajectory.”

Investigators noted, however, that analysis of additional prospective data about the new workflow’s impact on oncologic outcomes and patient quality-of-care metrics is still ongoing.

“There was no difference in the time from initial biopsy diagnosis to initial surgical consultation, biopsy to initial medical oncology consultation, biopsy to port placement, or biopsy to chemotherapy initiation,” Vaghijani and coinvestigators added.

Reference

Vaghjiani R, Sarkar J, Stiles Z, et al. Effects of establishing a multidisciplinary pancreatic cancer clinic on time-to-treatment. J Clin Oncol. 2022;40(suppl 28):61. doi:10.1200/JCO.2022.40.28_ suppl.061