Open AccessEffects of Implementation of a National Fast Track Clinical Pathway for Hepatocellular Carcinoma in Western Denmark
Author(s) -
Gerda Elisabeth Villadsen,
Kira Simonsen,
Peter Ott,
Hendrik Vilstrup,
Henning Grønbæk
Publication year - 2019
Publication title -
journal of gastrointestinal and liver diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.641
H-Index - 48
eISSN - 1842-1121
pISSN - 1841-8724
DOI - 10.15403/jgld.2014.1121.281.dnk
Subject(s) - medicine , hepatocellular carcinoma , fast track , track (disk drive) , medline , oncology , general surgery , surgery , computer science , political science , law , operating system
Background & Aims: In 2009, the Danish Government instituted “Fast Track Clinical Pathways” (FTCP) to accelerate diagnosis and treatment of cancers including hepatocellular carcinoma (HCC). We examined how the implementation of FTCP affected the time from referral to diagnosis and treatment as well as the patient survival.Methods: 309 consecutive patients with suspected HCC were included, 79 referred during the period 2007- 2008 (before FTCP) and 230 during 2009-2011. Of those, 271 (88%) were diagnosed with HCC and 161 (60%) had cirrhosis, in most cases caused by alcohol.Results: The time from referral to the first visit was reduced from a mean 16.4 (11.5) to 5.4 (6) days (p<0.001) and the time from the first visit to the Multidisciplinary Tumour Conference (MDT) treatment decision from 34.9 (27.9) to 16.1 (14.4) days (p<0.001). The total time from referral to treatment was reduced from 53.2 (37.9) to 35.9 (23.1) days (p<0.001). There was a weak trend of improved survival after FTCP: 231 (147-368)vs. 293 (227-396) days (p=0.11).Conclusions: The implementation of FTCP reduced the total time from referral to treatment by three weeks; however, without significant effects on overall mortality. While shortened waiting time is a comfort for the patient, it remains to be elucidated whether it will change the prognosis.