Treatment guidelines quickly disseminated to community physicians, audit finds
FRIDAY, May 16 (HealthDay News) -- Partnerships between major academic cancer centers and community hospitals are a quick and effective way to spread cancer treatment advances, say researchers at Fox Chase Cancer Center in Philadelphia.
Most new cancer treatments are created at major academic centers and most cancer care is provided at community hospitals, noted the researchers, who conducted a quality control audit of hospitals associated with Fox Chase, a U.S. National Cancer Institute-designated Comprehensive Cancer Center.
The 26 hospitals that are part of the Fox Chase Partners Program have access to the most recent cancer treatment guidelines developed by Fox Chase and other member institutions of the National Comprehensive Cancer Network (NCCN).
"When research leads to significant changes in treatment, it can take years before community oncologists are able to fully adopt the new guidelines. What's unique about the (Fox Chase) Partners program is the timely transition of advances. The audit we conducted shows that our Partner physicians are highly compliant in incorporating recent advances in cancer treatment," Margaret O'Grady, director of care management and clinical operations of Fox Chase Cancer Partners, said in a prepared statement.
She and her colleagues reviewed the medical charts of 124 patients, age 65 or older, treated for stage III colon cancer at Partner hospitals between 2003 and 2006, and found high compliance with NCCN treatment guidelines, including obtaining a minimum of 12 lymph nodes at surgery, and the addition of oxaliplatin to adjuvant chemotherapy.
Almost all patients (123) received adjuvant chemotherapy, although only 76 (61 percent) received oxaliplatin, a chemotherapy agent shown to extend survival in this group of patients.
"At first glance, this number looked low, but as we probed further, we found that all but 11 patients who didn't receive oxaliplatin had documented co-morbidities or other concerns that precluded them from receiving this treatment," O'Grady said.
The audit also found that 74 percent of patients had at least 12 lymph nodes retrieved, which is critically important to cancer treatment planning.
Nearly all the patients (93 percent) received appropriate surveillance with history and physical exams at suggested intervals and routine CEA testing. Abdominal and pelvic surveillance CT was performed in 78 percent of patients.
"We found a drop-off in compliance (49 percent) regarding the documentation of discussions between the doctor and patient about age and life expectancy in relation to adjuvant chemotherapy," O'Grady said. "This discussion is important and informs decision-making."
The U.S. National Cancer Institute has more about cancer therapy.
-- Robert Preidt
SOURCE: Fox Chase Cancer Center, news release, May 15, 2008
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