Multidisciplinary Clinics for Colorectal Cancer Care Reduces Treatment Time.
INTRODUCTION
Management of locally advanced and metastatic colorectal cancer (CRC) requires the expertise of multiple specialists. Multidisciplinary clinics (MDCs) are a working model designed to facilitate delivery of coordinated care. The present study evaluated the effects of MDC on the time to treatment (TTT).


PATIENTS AND METHODS
Patients with CRC or locally advanced anal cancer who were evaluated at a single-institution MDC from January 2014 to October 2015 were identified from an institutional registry. The clinical characteristics and timelines for various aspects of treatment were retrospectively reviewed and recorded. A control population of patients not evaluated at the MDC was matched 1:2 by disease and the number of treating specialties. The primary endpoints were the TTT from diagnosis and the TTT from the first consultation.


RESULTS
A total of 105 patients were included: 35 were evaluated at the MDC and 70 were controls. The MDC patients experienced a 7.8-day shorter TTT from the first consultation (21.5 vs. 29.3 days; P = .01). The difference was greater for patients visiting 3 departments (21.3 vs. 30.6 days; P < .001). Patients requiring neoadjuvant chemoradiation accounted for most of the decreased interval compared with those requiring surgery alone as their first treatment. The proportion of patients initiating treatment within 3 weeks from the first consultation was greater for those seen in the MDC (57.1% vs. 30% for controls; P = .01).


CONCLUSION
Implementation of a multidisciplinary CRC clinic yielded decreased intervals from the first consultation to treatment in our institution. Focusing efforts to increase MDC usage will improve treatment efficiency and improve patient access.
['Kozak|Vanessa N|VN|', 'Khorana|Alok A|AA|', 'Amarnath|Sudha|S|', 'Glass|Katherine E|KE|', 'Kalady|Matthew F|MF|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000554:Ambulatory Care Facilities D001005:Anus Neoplasms D002173:Cancer Care Facilities D015179:Colorectal Neoplasms D005260:Female D006297:Health Services Accessibility D006801:Humans D008297:Male D008875:Middle Aged D020360:Neoadjuvant Therapy D010348:Patient Care Team D012042:Registries D012189:Retrospective Studies D061665:Time-to-Treatment
Time to treatment Colon cancer Process improvement Rectal cancer Timely care