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S26 Results of the national mesothelioma organisational audit

Thorax, 2019-12, Vol.74 (Suppl 2), p.A17 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. ;2019 Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0040-6376 ;EISSN: 1468-3296 ;DOI: 10.1136/thorax-2019-BTSabstracts2019.32

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  • Title:
    S26 Results of the national mesothelioma organisational audit
  • Author: Shantikatara, A ; Harden, S ; Darlison, L ; Beckett, PA
  • Subjects: Audits ; Biomarkers ; Lung cancer ; Mesothelioma
  • Is Part Of: Thorax, 2019-12, Vol.74 (Suppl 2), p.A17
  • Description: IntroductionThe National Lung Cancer Audit (NLCA) has previously demonstrated variation in provision of local services which relate to patient outcomes. As part of the National Mesothelioma Audit (funded by Mesothelioma UK), we have carried out an organisational audit across the UK to investigate access to services and organisation of multidisciplinary teams for malignant pleural mesothelioma (MPM) patients.MethodsLung cancer clinical leads across the United Kingdom were invited to complete an online survey. Email reminders were sent at intervals over a 6-week period, and the specialist nursing network was used to further encourage participation. Results were analysed in Microsoft Excel.ResultOverall there were 125 responses, equivalent to a 75% response rate (England 105, Wales 9, Scotland 7, N. Ireland 4). 46% of respondents stated that they see their MPM patients in the lung cancer clinic with only 13% having a specific pleural clinic.Access to investigation and treatment is shown in table 1.78% reported routinely staging patients according to IASLC TNM v8 and 94% reported routinely recording the pathological subtype of mesothelioma. 21% of organisations perform a PET-CT scan, and 17% use biomarkers as part of the diagnostic assessment, although the survey did not distinguish between routine and exceptional use. A tissue biopsy is carried if pleural cytology suggests MPM routinely in 61%, sometimes in 34% and rarely in 5%.95% of organisations routinely discuss MPM cases in the local lung cancer MDT. Whilst only 22% had a local MPM specialist MDT, 49% routinely discuss MPM patients in a regional specialist MDT. 19 of these regional specialist MDTs were identified through the survey (England 17, Wales 1, Scotland 1). 84% responded that the lung CNS acted as a key worker on MPM patients with only 14% having a mesothelioma specific CNS.ConclusionAccess to key investigations are treatment are generally good. It is interesting that PET-CT and biomarkers are used so frequently despite not being recommended in BTS guidelines. 78% staging and 94% subtyping are considerably better (54% and 57% respectively) directly measured in the last NMA audit, perhaps reflecting genuine improvements in practice, or alternatively over-optimistic assessment of local practice. A second phase of this audit will look in detail at the self-declared specialist MDTs.Abstract S26 Table 1
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0040-6376
    EISSN: 1468-3296
    DOI: 10.1136/thorax-2019-BTSabstracts2019.32
  • Source: ProQuest Databases
    Alma/SFX Local Collection
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