Diagnostic value and patient compliance of a pancreas-oriented multidisciplinary clinic: a retrospective analysis from a Chinese pancreatic disease center
10.3760/cma.j.issn.0529-5815.2019.12.008
- VernacularTitle: 胰腺肿瘤多学科门诊的诊断价值与患者依从性分析
- Author:
Jian′ang LI
1
;
Wenchuan WU
1
;
Yuan JI
2
;
Lingxiao LIU
3
;
Shengxiang RAO
4
;
Dansong WANG
1
;
Yiqun ZHANG
5
;
Xiuzhong YAO
4
;
Yue FAN
6
;
Cheng HUANG
7
;
Yuhong ZHOU
8
;
Wenhui LOU
1
Author Information
1. Department of Pancreatic Surgery, Zhongshan Hospital Fudan University, Shanghai 200032, China
2. Department of Pathology, Zhongshan Hospital Fudan University, Shanghai 200032, China
3. Department of Interventional Radiology, Zhongshan Hospital Fudan University, Shanghai 200032, China
4. Department of Radiology, Zhongshan Hospital Fudan University, Shanghai 200032, China
5. Endoscopy Center, Zhongshan Hospital Fudan University, Shanghai 200032, China
6. Department of Traditional Chinese Medicine, Zhongshan Hospital Fudan University, Shanghai 200032, China
7. Department of Liver Surgery, Zhongshan Hospital Fudan University, Shanghai 200032, China
8. Department of Medical Oncology, Zhongshan Hospital Fudan University, Shanghai 200032, China
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Diagnosis;
Multidisciplinary team clinic;
Pancreatic diseases;
Patient compliance
- From:
Chinese Journal of Surgery
2019;57(12):912-916
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the role of multidisciplinary team (MDT) clinic in the diagnosis of pancreatic diseases and patient compliance with MDT advice in the current medical system.
Methods:The study included 512 patients that had visited the pancreas-oriented MDT clinic of Zhongshan Hospital between May 2015 and May 2019.The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. Compliance was determined according to whether a patient received corresponding therapies or undergoing further checks or follow-ups.
Results:Among the 512 patients that had visited the MDT clinic, 121 patients were referred due to undetermined diagnosis. Classified according to the final diagnosis, the rate of undetermined diagnosis in different disease categories from high to low in order was inflammatory diseases of the pancreas (75.0%, 24/32), other lesions of the pancreas (56.1%,23/41), pancreatic cystic lesions (19.1%,17/89), pancreatic carcinomas (18.3%,48/262) and pancreatic neuroendocrine neoplasms (pNEN)(10.2%,9/88). The MDT clinic made diagnosis to 68 patients directly with an accuracy of 89.7%. The rate of compliance in the entire cohort was 63.4%. The rate of compliance of patients from June 2017 to May 2019 (68.4%) was higher than that of patients from May 2015 to May 2017(59.6%). The compliance rate of patients in different disease categories from high to low in order was inflammatory diseases of the pancreas(84.4%, 27/32), pancreatic carcinomas (67.9%, 178/262), pNEN(60.2%,53/88), other lesions of the pancreas (56.1%,23/41), and pancreatic cystic lesions(49.4%, 44/89). The compliance rate of patients with different MDT advice from high to low in order was best supportive care(78.6%,22/28), antitumor approaches beyond surgery(71.6%,159/222), further tests(62.6%, 77/123), surgery(53.7%, 65/121) and follow-up(49.2%, 31/63). In patients suggested for surgery, the compliance rate of patients with carcinomas(67.4%, 33/49) was higher than patients with other kinds of neoplasms.
Conclusions:MDT clinic could facilitate the diagnosis of pancreatic diseases conveniently and inexpensively. The overall compliance rate of MDT clinic patients is rather low, and patients with carcinomas have a relative high rate of compliance with the suggestion of surgery.
