Definition of focal areas

Transcription

1 Organ-specific requirements for diagnosis and treatment in oncology centres The underlying aim is to discuss the various tumour entities in a joint, interdisciplinary, weekly conference. The tumour conference (TC) is the core structure for implementing interdisciplinary co-operation on the ground. A dedicated TC for individual tumour groups is possible if the case numbers of a specific tumour entity or the centre's structure so require. Amendment note The previous version D1 of 13 March 2011 was amended to include the focal area 6 "Urology. 1. Focal area 1: Oesophagus, stomach, bile ducts, primary hepatic tumours, GIST, neuroendocrine tumours 2. Tumour conference (TC) Interval: weekly Participants: Gastroenterology, haematology/oncology, pathology, radiology, radiotherapy, visceral surgery Pre-interventionally: consistently for all stages. Definition of further TC-presentations, depending on downstream diagnosis and treatment plan nutrition counselling endocrinology Mandatory participation in study projects/outcome research relevant to the specialty concerned 5. As appropriate, additional examination techniques / equipment requirements: endosonography (obligatory) octreotide scintigraphy (for NET) PET endoscopy + placement of stents mortality at 30 days (60 days for liver resections) anastomostic failure rate quality indicators of German evidence-based (S3) guideline to be observed R0 resections oesophagus, stomach, gall bladder, GIST In line with international classifications (e.g. TNM) and guidelines Ad 5: In addition to the equipment requirements listed in the survey form for OC (DKG - German Cancer Society) Definition Definiton focal areas 2012 DKG alle Rechte vorbehalten Page 1 von 6

2 1. Focal area 2: Malignant tumours of the musculoskeletal system (incl. soft tissue sarcomas*) 2. Tumour conference Interval: as needed; discussion within 1 week Participants: Haematology/oncology, orthopaedics/trauma surgery, oncological/visceral surgery, pathology, plastic surgeon in the case of *, radiology, radiotherapy Pre-interventionally (even pending histological evidence): consistently for all stages. Definition of further TC-presentations, depending on downstream diagnosis and treatment plan psycho-oncology (specially important considering length of treatment of predominantly young patients) dermatology plastic surgery occupational therapy reference pathology patients take part in studies, if possible mandatory participation in case of: osteogenic sarcomas, rhabdomyosarcoma, Ewing's sarcoma --- study participation (implementation of the complex, multidisciplinary therapy sequences) completeness of compartment resection (specify pathology) In line with international classifications (e.g. TNM) and guidelines Ad 5: In addition to the equipment requirements listed in the survey form for OC (DKG - German Cancer Society) Definition Definiton focal areas 2012 DKG alle Rechte vorbehalten Page 2 von 6

3 1. Focal area 3: CUP, locally treatable metastases, (unless the primary tumour is being treated at an organ cancer centre), special palliative issues related to advanced metastasised tumours 2. Tumour conference Interval: weekly Participants: Haematology/oncology, operative disciplines as the issue requires, palliative medicine, pathology, radiology, radiotherapy Depending on the issue: visceral and thorax surgery interventional endoscopy pain therapy wound management nutrition counselling (if necessary, parenteral nutrition) -- complex immunohistology and molecular biological testing PET-CT, as needed Conceivable meaningful QI: Establishment of processes to assess pain relief and quality of life In line with international classifications (e.g. TNM) and guidelines, where meaningful and available Definition Definiton focal areas 2012 DKG alle Rechte vorbehalten Page 3 von 6

4 1. Focal area 4: Endocrine malignancies (incl. thyroid, neuroendocrine tumours, NN) 2. Tumour conference: Interval: as needed; discussion within 1 week Participants: Gastroenterology, haematology/oncology, pathology, radiology, radiotherapy, thorax/visceral surgery (depending on tumour location) Mandatory for thyroid tumours: nuclear medicine, endocrinology Optional: endocrinology Pre-interventionally: consistently for all stages. Definition of further TC-presentations, depending on downstream diagnosis and treatment plan For thyroid: 1) preoperatively all patients scheduled for surgery because of clearly suspected malignancies. 2) all patients with distant metastases. However: not patients after complete surgery and prior to radioiodine treatment ---- Mandatory participation in study projects/outcome research relevant to the specialty concerned special nuclear medicine diagnostics (somatostatin-based imaging such as DOTATOC PET) and treatment/radioiodine treatment --- In line with international classifications (e.g. TNM) and guidelines Definition Definiton focal areas 2012 DKG alle Rechte vorbehalten Page 4 von 6

5 1. Focal area 5: Lymphomas, leukemias, plasmocytoma and other haematological system diseases 2. Tumour conference: Interval: as needed; discussion within 1 week Participants: Haematology/oncology, pathology, radiology, radiotherapy, Depending on the issue: operative disciplines, nuclear medicine Pre-interventionally: if the applicable guideline (DGHO - German Society for Haematology and Medical Oncology) stipulates interdisciplinary action or alternative treatment strategies are available; otherwise: consistently for all stages, and when changing treatments with therapeutic/diagnostic decision and definition of further TC-presentations reference pathology molecular biological diagnostics and immunohematology stem cell transplantation (if necessary, in cooperation) dermatology neurology Mandatory participation in study projects/outcome research relevant to the specialty concerned PET-CT (if necessary, in cooperation) --- In line with the international classifications and guidelines Definition Definiton focal areas 2012 DKG alle Rechte vorbehalten Page 5 von 6

6 1. Focal area 6: Tumours of the kidney, adrenal gland, urinary bladder, testicles and penis 2. Tumour conference Interval: weekly Participants: Urology (chair and organise the tumour conference), pathology, radiology, internal oncology, radiotherapy Associated specialty groups (e.g. nuclear medicine, visceral surgery, vascular surgery, endocrinology) to be included in the tumour conference as needed to ensure guideline-appropriate diagnosis and treatment Tumours to be presented: Pre-interventionally - all clinically invasive and metastasised tumours to determine the further course of treatment. stoma therapy pain therapy Mandatory participation in study projects/outcome research relevant to the specialty concerned. 5. Additionally necessary examination techniques and equipment and/or organisational requirements: interventional radiology PET - In line with the international classifications (such as TNM) and guidelines Enacted by the DKG: 18 March 2012 Definition Definiton focal areas 2012 DKG alle Rechte vorbehalten Page 6 von 6