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856 Audit to streamline multidisciplinary team meetings by implementing standard of care for early endometrial cancer cases
  1. P Bansal and
  2. FA Sefre
  1. Northampton General Hospital, Northampton, UK


Introduction/Background*Multi-disciplinary team(MDT) meetings are the core component of the UK’s cancer services. Over the last decade, incidence rates for all cancers combined have increased by a twentieth (5%) in the UK. UK’s health services have changed significantly since the introduction of MDT in 1995 and MDT are already under considerable pressure.

In 2020 NHS CANCER ALLIANCES published guidance on how MDTs can streamline to focus time on more complex cases through the introduction of Standards of Care (SoCs)

Methodology at Northampton general hospital ,we determined the SoCs for early endometrial endometriod cancer(EEC) and uterine sarcomas in accordance to BGCS guidelines. Then conducted an audit , examined the uterine cancer cases discussed in MDTs retrospectively over the period of nov 2020 to march 2021 .Cases which were reviewed are endometrial endometriod cancer (FIGO stage 1) and cases of fibroid uterus discussed due to suspicion of uterine sarcomas.In total 63 EEC and 18 fibroid uterus cases were discussed in 21 MDT meetings over 5 months.

Result(s)*Radiologically and histologically the cases were in concordance to the initial reporting thus not affecting the management decision of EEC . 20% of EEC and 38% of fibroid uterus cases were discussed moe than once due to logistical issues. Of Fibroid uterus cases , 84% turned out to be benign and 15% malignancies.MDT discussion could not contribute to the sarcomas as radiologically degenerating fibroids vs sarcoma decision was inconclusive leading to standard laparotomy and debulking decision, after ruling out extra uterine disease.

Conclusion*Recommendations drawn of this audit will now be implemented as- Each MDT will have a separate section as not for full discussion list. These cases will only be discussed if there is any doubt, any queries, or new information becomes available. Regular audit will be conducted of cases not discussed in relation to the appropriateness of patients receiving a SoC and their outcome on the following grounds-

Percentage of patients assigned to SoC compared to overall caseload to assess scope of streamlining. How is streamlining impacting on time for those patient cases which require discussion? What is the impact on total length of the MDT.

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