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Objective

AUDIT OF COMPLIANCE WITH NHSCSP GUIDELINES REQUIRING MDT REVIEW OF ALL CERVICAL CANCER PATIENTS Dr. M Bhattacharjee Dr. A Mutton Dr. S Nagarajan. Objective. To ascertain whether the Histopathology of all cervical cancer patients was discussed at the Gynaecology MDT as per NHSCSP guidelines.

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Objective

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  1. AUDIT OF COMPLIANCE WITH NHSCSP GUIDELINES REQUIRING MDT REVIEW OF ALL CERVICAL CANCER PATIENTSDr. M Bhattacharjee Dr. A Mutton Dr. S Nagarajan

  2. Objective • To ascertain whether the Histopathology of all cervical cancer patients was discussed at the Gynaecology MDT as per NHSCSP guidelines.

  3. Methods. • A retrospective computer (SNOMED) search of the pathology database was performed to identify all cervical cancer histological specimens reported during a one year period between January and December 2011. Those biopsies reported in unit hospitals outside South Tees Trust were not included.

  4. Cont. • Departmental protocol dictates supplementary report to be issued on every case reviewed at the MDT. • Among these, cases with supplementary report were identified.

  5. Cont. • In those without supplementary reports, the MDT co-ordinator’s record was used to ascertain whether they had been discussed at the MDT. • The cases were further analysed on the basis of other parameters such as specimen type and the type of cancer.

  6. Results. • Total number of specimens – 51. • Total number of patients – 41.

  7. Results • Types of specimen: • Cervical punch biopsy – 12 (23.5%). • Cervical LLETZ biopsy – 22 (43.1%). • Radical hysterectomy – 16 (31.5%). • Endometrial fluid – 1 (1.9%).

  8. Types of specimen

  9. Squamous cell carcinoma – 39. Adenocarcinoma – 10. Poorly differentiated carcinoma – 2. Histological Tumour Types.

  10. Histological Tumour Types.

  11. Results • 31 patients had a FIGO stage. Of them • 12 (39%) – 1A1 • 16 (52%) – 1B1 • 1 (3%) - 1B2 • 2 (6%) - 2A

  12. Results • Out of the 22 LLETZ biopsies 3 had no residual tumour in the subsequent hysterectomy specimen. • Of them • 1 was FIGO stage 1A1 • 2 were FIGO stage 1B1

  13. MDT Review. • Out of the 51 specimens: • 49 specimens (96.1%) had a supplementary report sequence 2 in the pathology database to indicate MDT review. • 2 specimens (3.9%) had no supplementary report in the pathology database.

  14. MDT Review. • MDT co-ordinator contacted to verify information on these 2 cases. • One was a private case and opted to shift region for treatment. • The other had been discussed at the MDT according to the MDT co-ordinator’s records. • Therefore in reality all patients (100% compliance) were discussed at the MDT.

  15. Conclusions. • Out of a total of 41 patients with cervical cancer, 40 were discussed at the MDT (one patient opted to shift region). • 1 patient (2%) had no supplementary report sequence 2 but had been discussed at the MDT (confirmed by the MDT co-ordinator).

  16. Conclusions. • Of the cervical cancers during the study period, 76% were squamous cell carcinomas, 20% were adenocarcinomas and 4% were poorly differentiated carcinomas. • This is broadly in line with the relative incidence of the different histological types of cervical cancer

  17. THANK YOU.

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