Abstract
1Department of Urology, Queen Elizabeth University Hospital, Glasgow, UK
2Department of Urology, Western General Hospital, Edinburgh, UK
Background
With increasing cancer diagnoses and survivorship the burden on the MDT meeting is increasing and mechanisms are sought to optimise discussion. Streamlining straightforward cases to registration and audit, rather than discussion, has been suggested. This is currently used in the East of Scotland but not in the West. Here we propose a method of streamlining in uro-oncology MDTs and assess the potential impact this would have on Greater Glasgow and Clyde.
Methods
Local and national guidance was reviewed and ongoing clinical trials were considered when defining potential streamlining criteria defined (Figure). These criteria were then applied to 100 consecutive cases of prostate, renal and bladder cancer discussed at the Greater Glasgow and Clyde MDTs.
Results
8% of renal, 24% of prostate and 24% of bladder cancers could be streamlined. Patient specific factors meant 2% of renal, 4% of prostate and 3% bladder cases, although eligible on disease criteria, could not be streamlined. There was insufficient information to reach a decision in 7% of all cases.
Conclusion
Streamlining cases to registration rather than discussion would reduce the burden on meeting time. An understanding of patient specific factors is necessary as protocolising based on disease criteria alone is not appropriate for all. Streamline criteria need refinement, testing and agreement, ideally nationally, and we acknowledge the process has some drawbacks, including quality of referral information and time burden of vetting the list.
