Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

A review of the optimal cancer care pathway for high grade glioma in Tasmania – An opportunity for improved patient and carer outcomes. (#193)

Rachel E Nimmo 1 , Rosemary Harrup 1 , Imogen Ibbett 1 , Martin Nettle 1
  1. The Royal Hobart Hospital, Hobart, TASMANIA, Australia

Primary brain tumours represent 2% of adult malignancy.  There is high patient morbidity and mortality, especially for high grade glioma (HGG), the most common form.  Approximately 35 adult patients are diagnosed with HGG in Tasmania annually with a median survival of 6.2 months.(1)  Multidisciplinary management is recommended to optimise treatment outcomes as outlined in the evidence based Optimal Cancer Care Pathway (OCP).(2,3)  A retrospective review of all patients with a new diagnosis of HGG at the Tasmanian Health Service (THS) during a 6 month period (01/01/16–30/06/2016) recorded demographics and timeline of sentinel events to determine concordance with HGG OCP.  15 patients (12 male) were identified.  Median age was 59.5 (range 42-88) years.  Of the 47% who died within 12 months of diagnosis there was a median survival of 3.5 (range 0.5-10) months.  In pathway stages 2, 3 and 4: 80% had diagnostic imaging within 24 hours of admission, 73% had a tissue diagnosis within one week of presentation, 100% had oncological review within 4 weeks of diagnosis, and 86% commenced oncological treatment within 6 weeks of diagnosis.  43% of patients were presented at a multidisciplinary meeting including consideration for clinical trials. In pathway stages 5 and 6: 10 (67%) patients had hospital readmission, median of 1.5 (range 0-7).  Allied health intervention was common (86% social work, 66% speech pathology, 80% occupational therapy, 73% physiotherapy and 37% dietetics).  37% were referred to palliative medicine and 87% had goals of care completed.  The THS is meeting the HGG OCP stages 2, 3 and 4.  There are deficiencies in stages 5, 6 and 7 which we will address with the implementation of improved patient and carer education in symptom management.

  1. 1. Loretta TS Ho, Alison Venn, Petr Otahal, Rosemary A Harrup. Management of Glioma in Tasmania (2006-08): Retrospective cohort study. MOGA ASM Melbourne 2013. (Poster presentation)
  2. 2. Lin E, Rosenthal MA, Le BH, Eastman P. Neuro-oncology and palliative care: a challenging interface. Neuro-Oncology. 2012;14(Suppl 4):iv3-iv7.
  3. 3.