PROMEDICA MONROE REGIONAL HOSPITAL 2016 Annual Report Includes Data Collected Through 2015
Welcome from the Cancer Committee Leadership With great pleasure, we present the 2016 ProMedica Monroe Regional Hospital Oncology Program Annual Report. We have the distinct privilege to serve as leaders for the Cancer Committee. Dedicated, hardworking and compassionate, our team delivers cancer care to the heart of our program our patients. ProMedica Monroe Regional Hospital provides access to superior, convenient healthcare services to Monroe, Mich., and the surrounding communities in southeastern Michigan. Patients who are diagnosed with cancer may be referred to the ProMedica Monroe Cancer Center, the area s only integrated facility that offers coordinated outpatient radiation therapy and chemotherapy in one convenient location. Accreditations by the American College of Surgeons Commission on Cancer in 2013, receiving renewal with commendation, and the American College of Radiology in 2014 ensure ProMedica Monroe Regional Hospital s commitment to quality oncology services for our patients. Throughout 2016, we have remained committed to providing the highest-quality cancer care and have shown our dedication to excellence in clinical quality, patient safety and customer service. Michael J. Charboneau Jr., DO General Surgeon Cancer Committee Chairman Charu Trivedi, MD Medical Oncologist Cancer Committee Liaison Physician 1
ProMedica Monsroe Regional Hospital Cancer Committee Membership 2016 Physician Members Discipline Michael Charboneau, DO General Surgery Cancer Committee Chairman Charu Trivedi, MD Medical Oncology/Cancer Conference Coordinator CoC Liaison Physician Celeste Batchev, MD Gehring Sauter, MD Steven Rubin, MD Gary Moorman, DO, FACOEP, FACEP, FAODME Khaled Shahrour, MD Navin Jain, MD Additional Members Megan Carolin Robin Sulier Charney, BA, MA Dianne Cherry Doreen Cutway Kristin Ferreira, OTRC Gail Gedelian, RT,(R), (M), (BD) Marcia Grandsko, RDN.LD Teressa Hopkins Ann Kujawa, MSN, RN, OCN Larry Lyons, M.Div, CBC Tina Melonakos, PharmD Cindy Miller, BS, RTT Kelly Morse, MS, LCGC Debra Osentoski, RN, BSN, OCN, CBCN Brian Paules, BS, CCT Mary Russ, RN, ACM Rick Russell, BSN, RN Nema Sanderson, BSN, RN Pamela Urbanski, MSN, RN Karen Whitmire, RN, OCN Kristy Williams, RHIT, CTR Wendy Woelmer, MSN, RN- BC Jeannie Yonkee, LSW Pathology Radiology Radiation Oncology Senior Vice President, Medical Affairs and Chief Medical Officer Urology Pulmonology Discipline American Cancer Society Community Outreach Coordinator The Victory Center Director, Marketing Communications Director, Rehabilitation Services Radiology Nutrition Medical Education Program Vice President, ProMedica Cancer Institute Pastoral Care Pharmacy Radiology Genetics Nurse Navigator Quality Improvement/Coordinator of Quality Improvement Case Management Hospice Palliative Medicine Vice President, Nursing Oncology Program Coordinator/Clinical Trials Cancer Registry/Coordinator Quality Control of Registry Data Senior Nurse Education Social Work/Coordinator of Psychosocial Services 2
Overview of 2015 Data In 2015, the ProMedica Monroe Regional Hospital (PMRH) cancer registry accessioned 306 new cases and it now contains more than 2,400 cases since the Cancer Program s reference date in 2007. Aggregate data from the cancer registry is routinely analyzed by the cancer committee and serves as a valuable resource for oncology clinicians and program administrators. In addition to recording new cases annually, the cancer registry conducts at least once yearly follow-up on all living patients in the database. The Commission on Cancer sets a standard of 90% follow-up rate for eligible cases from the last five years and, in 2016, the cancer registry maintained a follow-up rate of 92.7%. The cancer registry has maintained a 91.1% overall follow-up rate since its 2007 reference date; this exceeds the Commission on Cancer s standard of 80%. Compliance of these standards allows for accurate analysis of survival outcomes and disease recurrence rates as well as monitors development of secondary malignancies. Graph No. 1 illustrates the accession trends from 2007 through 2015. Analytic cases are those cases that were diagnosed and/or received initial definitive treatment at PMRH. Analytic cases are followed annually and included in all survival, outcome and quality monitored data. Non-analytic cases are cases that were initially diagnosed and treated elsewhere and then came to our facilities with progressive or recurrent disease. The average number of new cases is about 275 each year. Graph No. 1: ProMedica Monroe Regional Hospital Accession Trend, 2007-2015 Number of Cancer Diagnoses 4 212 33 248 43 12 270 264 17 308 31 19 11 289 273 281 57 306 2007 2008 2009 2010 2011 2012 2013 2014 2015 Analytic Non-Analytic 3
Table No. 1 illustrates the numbers of new cases accessioned by primary site as well as the AJCC stage at diagnosis for analytic cases. Table No. 1: ProMedica Monroe Regional Hospital 2015 Primary Site Distribution Class Total Sex of Cases Case AJCC Stage at Diagnosis* M F ANA NA 0 I II III IV N/A UNK Head and Neck Tongue 4 2 2 3 1 0 1 0 0 2 1 0 Salivary Glands 1 1 0 1 0 0 0 0 0 1 0 0 Tonsil 3 3 0 2 1 0 0 0 0 2 1 0 Hypo- and Nasopharynx 3 2 1 1 2 0 0 0 0 1 2 0 Larynx 5 5 0 3 2 0 2 0 0 1 2 0 DIGESTIVE SYSTEM Stomach 7 5 2 6 1 0 0 0 2 3 1 1 Colon 23 9 14 23 0 1 0 9 7 6 0 0 Rectum/Rectosigmoid 7 6 1 7 0 0 1 2 2 2 0 0 Anus, Anal Canal and Anorectum 5 1 4 4 1 0 0 2 1 0 1 1 Liver/Intrahepatic Bile Duct 2 0 2 0 0 0 1 0 0 1 0 0 Gallbladder 3 2 1 3 0 0 1 0 1 1 0 0 Pancreas 4 2 2 3 1 0 1 0 0 2 1 0 Other Biliary 1 1 0 1 0 0 0 1 0 0 0 0 RESPIRATORY SYSTEM Lung/Bronchus 56 33 23 53 3 0 9 5 12 26 3 1 Mesothelioma 1 0 1 1 0 0 0 0 1 0 0 0 BREAST 79 0 79 73 6 14 34 14 8 3 6 0 FEMALE GENITAL SYSTEM Cervix Uteri 15 0 15 2 13 0 1 0 1 0 13 0 Corpus Uteri 10 0 10 8 2 0 3 1 3 0 2 1 Ovary 3 0 3 2 1 0 1 0 0 1 1 0 Vulva 5 0 5 0 5 0 0 0 0 0 5 0 Peritoneum 1 0 1 1 0 0 0 0 0 1 0 0 MALE GENITAL SYSTEM Prostate Gland 36 36 0 34 2 0 7 17 3 7 2 0 Testis 1 1 0 1 0 0 0 1 0 0 0 0 URINARY SYSTEM Urinary Bladder 29 22 7 25 4 11 8 5 1 0 4 0 Kidney and Renal Pelvis 3 2 1 3 0 0 1 0 1 0 1 0 Ureter 1 1 0 1 0 0 0 0 0 1 0 0 SKIN Melanoma 3 3 0 1 2 0 0 1 0 0 2 0 CENTRAL NERVOUS SYSTEM Cranial Nerves/Other CNS 10 1 9 9 1 0 0 0 0 0 10 0 Brain 1 1 0 0 1 0 0 0 0 0 1 0 4
Table No.1, continued: 2015 Primary Site Distribution Class Total Sex of Cases Case AJCC Stage at Diagnosis* M F ANA NA 0 I II III IV N/A UNK ENDOCRINE SYSTEM Thyroid 2 0 2 2 0 0 2 0 0 0 0 0 Other Endocrine 2 1 1 1 1 0 0 0 0 0 2 0 LYMPHOMAS Hodgkin Lymphoma 1 1 0 0 1 0 0 0 0 0 1 0 Non Hodgkin Lymphoma 6 2 4 5 1 0 2 2 1 0 1 0 HEMATOPOIETIC Leukemia 10 7 3 8 2 0 0 0 0 0 10 0 Myeloma 2 0 2 2 0 0 0 0 0 0 2 0 Other Hematopoietic 4 3 1 2 2 0 0 0 0 0 4 0 UNKNOWN PRIMARY 14 8 6 14 0 0 0 0 0 0 14 0 ALL SITES COMBINED 363 161 202 305 56 26 75 60 44 61 93 4 *Collection of AJCC Stage is not required nor applicable for the following: Non-analytic cases, myeloma, leukemias, CNS tumors Graph No. 2 demonstrates how PMRH compares to national and state incidence rates. Due to having a dedicated breast imaging program and pulmonology and urology services, more breast, lung and urologic cancers are seen at PMRH when compared to national and Michigan data from the Commission on Cancer s National Cancer Database. Graph No. 2: 2015 ProMedica Monroe Regional Hospital Top Site Incidence Comparison Percent of New 2015 Cases 23.9 18.0 18.4 17.3 13.7 13 11.1 9.4 9.8 8.6 7.7 8.3 8.2 4.5 4.1 BREAST LUNG PROSTATE COLORECTAL BLADDER Monroe Michigan National 5
Lung Screening Program Outcomes ProMedica Monroe Regional Hospital (PMRH) is committed to helping our community fight cancer. One of the most effective ways is to promote awareness, prevention and the importance of early detection. Lung cancer is one of the Top 5 sites for PMRH based on its Community Needs Assessment and cancer registry data. In late 2015, PMRH collaborated with ProMedica Cancer Institute to offer lowdose CT (LDCT) scans at its facilities as well as at other ProMedica facilities, including Bay Park, Bixby, Defiance Regional, Flower, Fostoria Community, Herrick, Memorial, Monroe Regional and Toledo Hospitals. Based on screening guidelines from the National Cancer Comprehensive Network, a patient and their physician reviews set criteria to determine the patient s eligibility for LDCT. Also, by calling our screening phone number at 419-824-8851, patients can talk with the lung cancer nurse navigator to review and schedule a LCDT screening. The lung cancer nurse navigator tracks all scheduled screenings and results. When positive findings are found, the navigator calls the ordering physician and patient to assist with scheduling any required follow-up procedures or testing. Positive findings from additional testing are then followed up with an appointment with the ordering physician or at the weekly lung clinic held at ProMedica Flower Hospital. In 2016, 84 LDCT screenings were performed at PMRH with two positive lung cancer cases diagnosed. (See Graph No. 3.) Graph No. 3: ProMedica Monroe Regional Hospital Low-Dose CT Screenings for Lung Cancer 74 (88%) 2(2%) 8 (10%) Positive Biopsies* Required Further Work-up Within Normal Limits *The two positive biopsies were Stage I or Stage II and treated with lobectomy. 6