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Scientific article
English

Description and analysis of clinical pathways for oesophago-gastric adenocarcinoma, in 10 European countries (the EURECCA upper gastro intestinal group - European Registration of Cancer Care)

Published inEuropean journal of surgical oncology, vol. 42, no. 9, p. 1432-1447
Publication date2016-09
First online date2016-02-06
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.

eng
Keywords
  • Care pathway
  • Clinical pathway
  • EURECCA
  • Gastric cancer
  • National health policy
  • Oesophageal cancer
  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / pathology
  • Adenocarcinoma / therapy
  • Animals
  • Critical Pathways
  • Denmark
  • Esophageal Neoplasms / diagnosis
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / therapy
  • Europe
  • France
  • Gastroenterologists
  • Germany
  • Health Policy
  • Humans
  • Ireland
  • Italy
  • Neoplasm Staging
  • Netherlands
  • Oncologists
  • Patient Care Team
  • Poland
  • Quality of Health Care
  • Registries
  • Spain
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy
  • Surgeons
  • Surveys and Questionnaires
  • Sweden
  • Time Factors
  • United Kingdom
Affiliation Not a UNIGE publication
Citation (ISO format)
MESSAGER, M et al. Description and analysis of clinical pathways for oesophago-gastric adenocarcinoma, in 10 European countries (the EURECCA upper gastro intestinal group - European Registration of Cancer Care). In: European journal of surgical oncology, 2016, vol. 42, n° 9, p. 1432–1447. doi: 10.1016/j.ejso.2016.01.001
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Article (Published version)
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ISSN of the journal0748-7983
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