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Article ; Online: Referral patterns of GIST patients: data from a nationwide study.

Roets, Evelyne / Ijzerman, Nikki S / Ho, Vincent K Y / Desar, Ingrid M E / Reyners, Anna K L / Gelderblom, Hans / Grünhagen, Dirk J / Van Etten, Boudewijn / Van Houdt, Winan J / Van der Graaf, Winette T A / Steeghs, Neeltje

Acta oncologica (Stockholm, Sweden)

2024 Volume 63, Page(s) 28–34

Abstract: Background: This study compares the characteristics, referral and treatment patterns and overall survival (OS) of gastrointestinal stromal tumor (GIST) patients treated in reference and non-reference centers in the Netherlands.: Patients and methods: ...

Abstract	Background: This study compares the characteristics, referral and treatment patterns and overall survival (OS) of gastrointestinal stromal tumor (GIST) patients treated in reference and non-reference centers in the Netherlands. Patients and methods: This retrospective cohort study on patients diagnosed between 2016 and 2019, utilises data from the Netherlands Cancer Registry and the Dutch Nationwide Pathology Database. Patients were categorized into two groups: patients diagnosed in or referred to reference centers and patients diagnosed in non-reference centers without referral. Results: This study included 1,550 GIST patients with a median age of 67.0 in reference and 68.0 years in non-reference centers. Eighty-seven per cent of patients were diagnosed in non-reference centers, of which 36.5% (493/1,352) were referred to a reference center. Referral rates were higher for high-risk (62.2% [74/119]) and metastatic patients (67.2% [90/134]). Mutation analysis was performed in 96.9% and 87.6% of these cases in reference and in non-reference centers (p < 0.01), respectively. Systemic therapy was given in reference centers versus non-reference in 89.5% versus 82.0% (p < 0.01) of high-risk and in 94.1% versus 65.9% (p < 0.01) of metastatic patients, respectively. The proportion of positive resection margins and tumor rupture did not differ between reference and non-reference centers. Median OS was not reached. Conclusion: A substantial amount of metastatic GIST patients in non-reference centers did not receive systemic treatment. This might be due to valid reasons. However, optimisation of the referral strategy of GIST patients in the Netherlands could benefit patients. Further research is needed to explore reasons for not starting systemic treatment in metastatic GIST patients.
MeSH term(s)	Humans ; Gastrointestinal Stromal Tumors/therapy ; Gastrointestinal Stromal Tumors/drug therapy ; Antineoplastic Agents/therapeutic use ; Retrospective Studies ; Referral and Consultation ; Netherlands/epidemiology ; Gastrointestinal Neoplasms/epidemiology ; Gastrointestinal Neoplasms/therapy
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2024-02-14
Publishing country	England
Document type	Journal Article
ZDB-ID	896449-x
ISSN	1651-226X ; 0349-652X ; 0284-186X ; 1100-1704
ISSN (online)	1651-226X
ISSN	0349-652X ; 0284-186X ; 1100-1704
DOI	10.2340/1651-226X.2024.23722
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Zs.A 6348: Show issues

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Article ; Online: Comment on the RAPIDO Trial Point-Counterpoint Debate.

Nilsson, Per J / van Etten, Boudewijn / Hospers, Geke A P / Marijnen, Corrie A M / Meershoek-Klein Kranenberg, Elma / Roodvoets, Annet G H / van de Velde, Cornelis J H / Glimelius, Bengt

Diseases of the colon and rectum

2023 Volume 67, Issue 2, Page(s) e126

Language	English
Publishing date	2023-10-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000003138
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Article ; Online: Local recurrence in primary localised resected gastrointestinal stromal tumours: A registry observational national cohort study including 912 patients.

Bleckman, Roos F / Roets, Evelyne / IJzerman, Nikki S / Mohammadi, Mohammed / Bonenkamp, Han J J / Gelderblom, Hans / Mathijssen, Ron H J / Steeghs, Neeltje / Reyners, Anna K L / van Etten, Boudewijn

European journal of cancer (Oxford, England : 1990)

2023 Volume 186, Page(s) 113–121

Abstract: Background and objectives: Previous literature showed a high risk of recurrence following surgical treatment in patients with gastrointestinal stromal tumours (GISTs). However, little is known about the patient- and treatment characteristics of local ... ...

Abstract	Background and objectives: Previous literature showed a high risk of recurrence following surgical treatment in patients with gastrointestinal stromal tumours (GISTs). However, little is known about the patient- and treatment characteristics of local recurrences (LRs) in GIST patients. Therefore, this study aimed to better understand patterns of LR in surgically treated localised GIST and to describe treatment options based on our Dutch GIST Registry (DGR). Methods: Data of primary surgically treated localised GIST between January 2009 until July 2021 were retrospectively retrieved from the DGR. Results: Of 1452 patients registered in the DGR, 912 patients were included in this study. Only 3.8% (35/912) of patients developed LR, including 20 patients with LR only and 15 patients with simultaneous LR and distant metastases (DM). Median time to LR was 30 (interquartile range 8-53) months from date of surgery. Eleven percent (100/912) of patients developed only DM. A total of 2.3% (6/259) of patients treated with adjuvant treatment developed an LR during adjuvant therapy. Seventy percent of patients with LR only (14/20) were treated with surgery (85.7% R0), which was mostly combined with systemic treatment. Conclusions: Patients with primary surgically treated localised GIST have a limited risk of developing recurrence. Fifteen percent developed recurrence, of which one quarter developed an LR. Therefore, less intensified follow-up schedules could be considered, especially during treatment with adjuvant imatinib. In patients with LR only, potentially curative treatment strategies, including surgical (re-)resection, are often possible as treatment for LR.
MeSH term(s)	Humans ; Gastrointestinal Stromal Tumors/drug therapy ; Cohort Studies ; Retrospective Studies ; Imatinib Mesylate/therapeutic use ; Registries ; Neoplasm Recurrence, Local ; Antineoplastic Agents/therapeutic use
Chemical Substances	Imatinib Mesylate (8A1O1M485B) ; Antineoplastic Agents
Language	English
Publishing date	2023-03-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2023.03.007
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Article: Aesthetic Outcomes of Perineal Reconstruction with the Lotus Petal Flap.

Hellinga, Joke / Fleer, Joke / van der Lei, Berend / Werker, Paul M N / van Etten, Boudewijn / Stenekes, Martin W

Plastic and reconstructive surgery. Global open

2021 Volume 9, Issue 6, Page(s) e3621

Abstract: The lotus petal flap can be applied for reconstruction of extensive defects in the vulvoperineal area. Studies on aesthetic outcomes are lacking. This study aimed to fill this gap.: Methods: All patients who underwent lotus petal flap reconstruction ... ...

Abstract	The lotus petal flap can be applied for reconstruction of extensive defects in the vulvoperineal area. Studies on aesthetic outcomes are lacking. This study aimed to fill this gap. Methods: All patients who underwent lotus petal flap reconstruction between October 2011 and December 2015 were asked permission to have their photographs used. Two questionnaires were used: (1) the Strasser score to assess the overall aesthetic results (range 0-15) and (2) the Patient and Observer Scar Assessment Scale (POSAS; range 6-60). Six plastic surgeons and 6 laymen filled in the Strasser score and the Observer scale of the POSAS. Patients filled in the Strasser score, the Patient scale of the POSAS and scored their overall satisfaction with the aesthetic results on a Likert scale (0-10). Results: The photographs of 11 patients were included. The median Strasser score of all observers of 11.9 (range 0.0-75.0) indicated a mediocre aesthetic result. The median total POSAS score of 15.6 (range 6.0-41.0) indicated an aesthetically acceptable scar. Strasser and POSAS scores of the plastic surgeons and laymen did not differ significantly from the patients' scores. The patient satisfaction score with the aesthetic result was a median of 6.0 of 10. Conclusions: The findings indicate that, overall, patients were moderately satisfied with the aesthetic results of their lotus petal flap reconstructions, as were the plastic surgeons and laymen. For clinical practice, it is important that the plastic surgeon manages expectations carefully before surgery, as it is possible that patients might experience a rather low aesthetic outcome after perineal reconstruction.
Language	English
Publishing date	2021-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2851682-5
ISSN	2169-7574 ; 2169-7574
ISSN (online)	2169-7574
ISSN	2169-7574
DOI	10.1097/GOX.0000000000003621
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Zs.A 7091: Show issues

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Article ; Online: Re-Irradiation in Patients with Recurrent Rectal Cancer is Safe and Feasible.

Dijkstra, Esmée A / Mul, Véronique E M / Hemmer, Patrick H J / Havenga, Klaas / Hospers, Geke A P / Muijs, Christina T / van Etten, Boudewijn

Annals of surgical oncology

2021 Volume 28, Issue 9, Page(s) 5194–5204

Abstract: Background: There is no consensus yet for the best treatment regimen in patients with recurrent rectal cancer (RRC). This study aims to evaluate toxicity and oncological outcomes after re-irradiation in patients with RRC in our center. Clinical (cCR) ... ...

Abstract	Background: There is no consensus yet for the best treatment regimen in patients with recurrent rectal cancer (RRC). This study aims to evaluate toxicity and oncological outcomes after re-irradiation in patients with RRC in our center. Clinical (cCR) and pathological complete response (pCR) rates and radicality were also studied. Methods: Between January 2010 and December 2018, 61 locally advanced RRC patients were treated and analyzed retrospectively. Patients received radiotherapy at a dose of 30.0-30.6 Gy (reCRT) or 50.0-50.4 Gy chemoradiotherapy (CRT) in cases of no prior irradiation because of low-risk primary rectal cancer. In both groups, patients received capecitabine concomitantly. Results: In total, 60 patients received the prescribed neoadjuvant (chemo)radiotherapy followed by surgery, 35 patients (58.3%) in the reRCT group and 25 patients (41.7%) in the long-course CRT group. There were no significant differences in overall survival (p = 0.82), disease-free survival (p = 0.63), and local recurrence-free survival (p = 0.17) between the groups. Patients in the long-course CRT group reported more skin toxicity after radiotherapy (p = 0.040). No differences were observed in late toxicity. In the long-course CRT group, a significantly higher cCR rate was observed (p = 0.029); however, there was no difference in the pCR rate (p = 0.66). Conclusions: The treatment of RRC patients with re-irradiation is comparable to treatment with long-course CRT regarding toxicity and oncological outcomes. In the reCRT group, less cCR was observed, although there was no difference in pCR. The findings in this study suggest that it is safe and feasible to re-irradiate RRC patients.
MeSH term(s)	Chemoradiotherapy ; Humans ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local/radiotherapy ; Neoplasm Staging ; Re-Irradiation ; Rectal Neoplasms/pathology ; Rectal Neoplasms/radiotherapy ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-021-10070-6
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Article ; Online: Oncological outcomes after a pathological complete response following total neoadjuvant therapy or chemoradiotherapy for high-risk locally advanced rectal cancer in the RAPIDO trial.

Zwart, Wouter H / Temmink, Sofieke J D / Hospers, Geke A P / Marijnen, Corrie A M / Putter, Hein / Nagtegaal, Iris D / Blomqvist, Lennart / Kranenbarg, Elma Meershoek-Klein / Roodvoets, Annet G H / Martling, Anna / van de Velde, Cornelis J H / Glimelius, Bengt / Peeters, Koen C M J / van Etten, Boudewijn / Nilsson, Per J

European journal of cancer (Oxford, England : 1990)

2024 Volume 204, Page(s) 114044

Abstract: Background: A pathological complete response (pCR) following chemoradiation (CRT) or short-course radiotherapy (scRT) leads to a favourable prognosis in patients with rectal cancer. Total neo-adjuvant therapy (TNT) doubles the pCR rate, but it is ... ...

Abstract	Background: A pathological complete response (pCR) following chemoradiation (CRT) or short-course radiotherapy (scRT) leads to a favourable prognosis in patients with rectal cancer. Total neo-adjuvant therapy (TNT) doubles the pCR rate, but it is unknown whether oncological outcomes remain favourable and whether the same characteristics are associated with pCR as after CRT. Methods: Comparison between patients with pCR in the RAPIDO trial in the experimental [EXP] (scRT, chemotherapy, surgery, as TNT) and standard-of-care treatment [STD] (CRT, surgery, postoperative chemotherapy depending on hospital policy) groups. Primary and secondary outcomes were time-to-recurrence (TTR), overall survival (OS) and association between patient, tumour, and treatment characteristics and pCR. Results: Among patients with a resection within six months after preoperative treatment, 120/423 (28%) [EXP] and 57/398 (14%) [STD] achieved a pCR. Following pCR, 5-year cumulative TTR and OS rates in the EXP and STD arms were 8% vs. 7% (hazard ratio 1.04, 95%CI 0.32-3.38) and 94% vs. 93% (hazard ratio 1.41, 95%CI 0.51-3.92), respectively. Besides the EXP treatment (odds ratio 2.70, 95%CI 1.83-3.97), pre-treatment carcinoembryonic antigen (CEA) <5, pre-treatment tumour size <40 mm and cT2 were associated with pCR. Distance from the anal verge was the only characteristic with a statistically significant difference in association with pCR between the EXP and STD treatment (P Conclusions: The doubled pCR rate of TNT compared to CRT results in similar oncological outcomes. Characteristics associated with pCR are the EXP treatment, normal CEA, and small tumour size.
Language	English
Publishing date	2024-04-07
Publishing country	England
Document type	Journal Article
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2024.114044
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Article: Results of a diagnostic imaging audit in a randomised clinical trial in rectal cancer highlight the importance of careful planning and quality control.

Prata, Ilaria / Eriksson, Martina / Krdzalic, Jasenko / Kranenbarg, Elma Meershoek-Klein / Roodvoets, Annet G H / Beets-Tan, Regina / van de Velde, Cornelis J H / van Etten, Boudewijn / Hospers, Geke A P / Glimelius, Bengt / Nilsson, Per J / Marijnen, Corrie A M / Peeters, Koen C M J / Blomqvist, Lennart K

Insights into imaging

2023 Volume 14, Issue 1, Page(s) 206

Abstract: Background: Magnetic resonance (MR) imaging is the modality used for baseline assessment of locally advanced rectal cancer (LARC) and restaging after neoadjuvant treatment. The overall audited quality of MR imaging in large multicentre trials on rectal ... ...

Abstract	Background: Magnetic resonance (MR) imaging is the modality used for baseline assessment of locally advanced rectal cancer (LARC) and restaging after neoadjuvant treatment. The overall audited quality of MR imaging in large multicentre trials on rectal cancer is so far not routinely reported. Materials and methods: We collected MR images obtained within the Rectal Cancer And Pre-operative Induction Therapy Followed by Dedicated Operation (RAPIDO) trial and performed an audit of the technical features of image acquisition. The required MR sequences and slice thickness stated in the RAPIDO protocol were used as a reference. Results: Out of 920 participants of the RAPIDO study, MR investigations of 668 and 623 patients in the baseline and restaging setting, respectively, were collected. Of these, 304/668 (45.5%) and 328/623 (52.6%) MR images, respectively, fulfilled the technical quality criteria. The main reason for non-compliance was exceeding slice thickness 238/668, 35.6% in the baseline setting and 162/623, 26.0% in the restaging setting. In 166/668, 24.9% and 168/623, 27.0% MR images in the baseline and restaging setting, respectively, one or more of the required pulse sequences were missing. Conclusion: Altogether, 49.0% of the MR images obtained within the RAPIDO trial fulfilled the image acquisition criteria required in the study protocol. High-quality MR imaging should be expected for the appropriate initial treatment and response evaluation of patients with LARC, and efforts should be made to maximise the quality of imaging in clinical trials and in clinical practice. Critical relevance statement: This audit highlights the importance of adherence to MR image acquisition criteria for rectal cancer, both in multicentre trials and in daily clinical practice. High-resolution images allow correct staging, treatment stratification and evaluation of response to neoadjuvant treatment. Key points: - Complying to MR acquisition guidelines in multicentre trials is challenging. - Neglection on MR acquisition criteria leads to poor staging and treatment. - MR acquisition guidelines should be followed in trials and clinical practice. - Researchers should consider mandatory audits prior to study initiation.
Language	English
Publishing date	2023-11-24
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	2543323-4
ISSN	1869-4101
ISSN	1869-4101
DOI	10.1186/s13244-023-01552-0
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Article ; Online: Risk and location of distant metastases in patients with locally advanced rectal cancer after total neoadjuvant treatment or chemoradiotherapy in the RAPIDO trial.

Bahadoer, Renu R / Hospers, Geke A P / Marijnen, Corrie A M / Peeters, Koen C M J / Putter, Hein / Dijkstra, Esmée A / Kranenbarg, Elma Meershoek-Klein / Roodvoets, Annet G H / van Etten, Boudewijn / Nilsson, Per J / Glimelius, Bengt / van de Velde, Cornelis J H

European journal of cancer (Oxford, England : 1990)

2023 Volume 185, Page(s) 139–149

Abstract: Introduction: Although optimising rectal cancer treatment has reduced local recurrence rates, many patients develop distant metastases (DM). The current study investigated whether a total neoadjuvant treatment strategy influences the development, ... ...

Abstract	Introduction: Although optimising rectal cancer treatment has reduced local recurrence rates, many patients develop distant metastases (DM). The current study investigated whether a total neoadjuvant treatment strategy influences the development, location, and timing of metastases in patients diagnosed with high-risk locally advanced rectal cancer included in the Rectal cancer And Pre-operative Induction therapy followed by Dedicated Operation (RAPIDO) trial. Material and methods: Patients were randomly assigned to short-course radiotherapy followed by 18 weeks of CAPOX or FOLFOX4 before surgery (EXP), or long-course chemoradiotherapy with optional postoperative chemotherapy (SC-G). Assessments for metastatic disease were performed pre- and post-treatment, during surgery, and 6, 12, 24, 36, and 60 months postoperatively. From randomisation, differences in the occurrence of DM and first site of metastasis were evaluated. Results: In total, 462 patients were evaluated in the EXP and 450 patients in the SC-G groups. The cumulative probability of DM at 5 years after randomisation was 23% [95% CI 19-27] and 30% [95% CI 26-35] (HR 0.72 [95% CI 0.56-0.93]; P = 0.011) in the EXP and SC-G, respectively. The median time to DM was 1.4 (EXP) and 1.3 years (SC-G). After diagnosis of DM, median survival was 2.6 years [95% CI 2.0-3.1] in the EXP and 3.2 years [95% CI 2.3-4.1] in the SC-G groups (HR 1.39 [95% CI 1.01-1.92]; P = 0.04). First occurrence of DM was most often in the lungs (60/462 [13%] EXP and 55/450 [12%] SC-G) or the liver (40/462 [9%] EXP and 69/450 [15%] SC-G). A hospital policy of postoperative chemotherapy did not influence the development of DM. Conclusions: Compared to long-course chemoradiotherapy, total neoadjuvant treatment with short-course radiotherapy and chemotherapy significantly decreased the occurrence of metastases, particularly liver metastases.
MeSH term(s)	Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Chemoradiotherapy ; Rectum/pathology ; Rectal Neoplasms/pathology ; Neoplasms, Second Primary/pathology ; Neoplasm Recurrence, Local/pathology ; Treatment Outcome ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Language	English
Publishing date	2023-03-07
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	82061-1
ISSN	1879-0852 ; 0277-5379 ; 0959-8049 ; 0964-1947
ISSN (online)	1879-0852
ISSN	0277-5379 ; 0959-8049 ; 0964-1947
DOI	10.1016/j.ejca.2023.02.027
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Article ; Online: Quality of Life, Sexual Functioning, and Physical Functioning Following Perineal Reconstruction with the Lotus Petal Flap.

Hellinga, Joke / Stenekes, Martin W / Werker, Paul M N / Janse, Moniek / Fleer, Joke / van Etten, Boudewijn

Annals of surgical oncology

2020 Volume 27, Issue 13, Page(s) 5279–5285

Abstract: Background: Lotus petal flaps (LPF) may be used for the reconstruction of extralevator abdominoperineal defects that cannot be closed primarily. Limited data are available on how perineal reconstruction with the LPF impacts on patients' quality of life ( ...

Abstract	Background: Lotus petal flaps (LPF) may be used for the reconstruction of extralevator abdominoperineal defects that cannot be closed primarily. Limited data are available on how perineal reconstruction with the LPF impacts on patients' quality of life (QoL), sexual functioning, and physical functioning. Methods: A cross-sectional study was performed following perineal reconstruction with the LPF. The QoL of patients having undergone LPF reconstruction was compared with a control group in which perineal defects were closed without flaps. Sexual and physical functioning (presence of perineal herniation and range of motion [ROM] of the hip joints) could only be evaluated in the LPF group. Psychometrically sound questionnaires were used. Physical functioning was evaluated subjectively with binary questions and objectively by physical examination. Results: Of the 23 patients asked to participate, 15 (65%) completed the questionnaires and 11 (47%) underwent physical examination. In the control group, 16 patients were included. There were no significant differences in QoL between the LPF and control groups. Within the LPF group, 33% of patients were sexually active postoperatively compared with 87% preoperatively. No perineal herniation was found. The ROM of the hip joints was bilaterally smaller compared with the generally accepted values. Conclusions: Conclusions should be made with care given the small sample size. Despite a supposedly larger resection area in the LPF group, QoL was comparable in both groups. Nonetheless, reconstruction seemed to affect sexual function and physical function, not hampering overall satisfaction.
MeSH term(s)	Cross-Sectional Studies ; Humans ; Male ; Perineum/surgery ; Quality of Life ; Reconstructive Surgical Procedures ; Rectal Neoplasms/surgery ; Surgical Flaps
Language	English
Publishing date	2020-07-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-020-08771-5
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Article: Reorganizing the Multidisciplinary Team Meetings in a Tertiary Centre for Gastro-Intestinal Oncology Adds Value to the Internal and Regional Care Pathways. A Mixed Method Evaluation.

van Huizen, Lidia S / Dijkstra, Pieter U / Hemmer, Patrick H J / van Etten, Boudewijn / Buis, Carlijn I / Olsder, Linde / van Vilsteren, Frederike G I / Ahaus, Kees C T B / Roodenburg, Jan L N

International journal of integrated care

2021 Volume 21, Issue 1, Page(s) 8

Abstract: Introduction: The reorganisation of the structure of a Gastro-Intestinal Oncology Multidisciplinary Team Meeting (GIO-MDTM) in a tertiary centre with three care pathways is evaluated on added value.: Methods: In a mixed method investigation, process ... ...

Abstract	Introduction: The reorganisation of the structure of a Gastro-Intestinal Oncology Multidisciplinary Team Meeting (GIO-MDTM) in a tertiary centre with three care pathways is evaluated on added value. Methods: In a mixed method investigation, process indicators such as throughput times were analysed and stakeholders were interviewed regarding benefits and drawbacks of the reorganisation and current MDTM functioning. Results: For the hepatobiliary care pathway, the time to treatment plan increased, but the time to start treatment reduced significantly. The percentage of patients treated within the Dutch standard of 63 days increased for the three care pathways. From the interviews, three themes emerged: added value of MDTMs, focus on planning integrated care and awareness of possible improvements. Discussion: The importance of evaluating interventions in oncology care pathways is shown, including detecting unexpected drawbacks. The evaluation provides insight into complex dynamics of the care pathways and contributes with recommendations on functioning of an MDTM. Conclusions: Throughput times are only partly determined by oncology care pathway management, but have influence on the functioning of MDTMs. Process indicator information can help to reflect on integration of care in the region, resulting in an increase of patients treated within the Dutch standard.
Language	English
Publishing date	2021-02-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2119289-3
ISSN	1568-4156
ISSN	1568-4156
DOI	10.5334/ijic.5526
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In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

Full text online

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito