Management of Patients with Gastric or Gastroesophageal Junction Cancer: From Theory to Integrated Clinical Pathways Implementation in the Real World.
V. 173 N. 4 (2022), Research article
V. 173 N. 4 (2022)

Management of Patients with Gastric or Gastroesophageal Junction Cancer: From Theory to Integrated Clinical Pathways Implementation in the Real World. : doi: 10.7417/CT.2022.2440

Research article
Pubblicato 2022-07-20
R. Guggino
Service of Clinical Nutrition, ASP Palermo, Italy
M. Spada
4. Medical Oncology Unit, Fondazione Istituto Giglio, Cefalù, Palermo, Italy
N. Borsellino
Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo, Italy
M. Spada
Medical Oncology Unit, Fondazione Istituto Giglio, Cefalù, Palermo, Italy
F. Verderame
Medical Oncology Unit, Ospedale Cervello Villa Sofia, Palermo
P. Mezzatesta
Surgical Oncology Unit, La Maddalena Clinic for Cancer, Palermo
P. Marchesa
Surgical Oncology Unit, ARNAS, Palermo, Italy
A. Firenze
Risk Management Unit, Policlinico Paolo Giaccone, University of Palermo, Italy
F. Cartabellotta
Department of Internal Medicine, Ospedale Buccheri La Ferla, Palermo
I. Fazio
Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
S. Pergolizzi
Radiotherapy Unit, Policlinico Barresi, Messina, Italy.
C. Callari
Surgical Unit, Ospedale Buccheri La Ferla, Palermo, Italy
V. Gebbia
GSTU Foundation for Cancer Research, Palermo, Italy - Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties – Promise, University of Palermo, Italy - Medical Oncology Unit, La Maddalena Clinic for Cancer, Palermo, Italy
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Parole chiave

esophagogastric junction cancer
gastric cancer
clinical pathways
multidisciplinary teams
flowchart

Abstract

Background: Best care of esophagogastric junction and gastric cancer ((EGC) requires a complex, timely interaction between members of a multi-disciplinary team (MDT). An integrated clinical pathway (ICP) is necessary to achieve this goal as well as the implementation of its use in daily practice.

Objective: To elaborate on an integrated clinical pathway for the multi-disciplinary management of ECG. Authors also put in act an implementation program to improve adherence to guidelines thought an ICP.

Setting: Prospective work carried out by a multi-institutional MDT in Italy.

Method: Identified expert panel extracted relevant recommendations and/or statements from published papers and guidelines obtaining a set of crucial interventions employed the Estimate-Talk-Estimate method. A flow-chart diagram was elaborated to elicit the process at a glance.

Primary outcome measure: Elaboration of an ICP with a high consensus rate also reported as a snapshot diagram and its implementation in daily clinical practice. An accredited certification body agency validated results, and an implementation process was started in several hospitals known to treat ECG.

Results: A methodologist aggregated a multi-disciplinary panel of experts from different institutions. The panel elaborated a flow-chart diagram with crucial intervention highlight and connecting lines, as well as outcome measures. An accredited certification body agency validated the entire process, representing the basis for empowerment and implementation among patients and oncological professionals in various hospitals.

Conclusion: The multi-disciplinary and multi-institutional expert panel successfully elaborated on a validated ICP for all stages ECG. An in-hospital implementation program has been  programmed

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