| 抄録 |
During the last decades, few fields of medicine have advanced as much as oncology, and the advent of new diagnostic and treatment modalities has rendered the management of patients highly personalized and complex. State-of-the art care of the oncology patient now often requires the prompt cooperation of physicians of several specialties. In most hospitals, multidisciplinary care consists of separate clinic visits with various specialists in conjunction with a weekly tumor board discussion. One reason for the emphasis on this approach is the accumulating evidence that multidisciplinary care leads to more favorable patient outcomes. In this regard, contemporary recommendations support the management of oncologic patients by a multidisciplinary team, including surgical oncologists, medical oncologists, radiation oncologists, interventional radiologists, pathologists, and other specialties. While most hospitals that deliver cancer care have weekly tumor boards, fewer hospitals have actual single-day multidisciplinary clinics. From the patient’s perspective, a single-day multidisciplinary clinic visit is less stressful and more convenient than multiple visits to physicians of different specialties, and may lead to faster delivery of care and higher adherence to physicians’ recommendations. Multidisciplinary clinics can, however, be more resource intense, as well as require providers to deviate from their normal clinic routine. Primary and secondary malignancies of the liver may be particularly well suited for a single-day multidisciplinary clinic approach. Primary liver cancer is the 5th most common cancer in terms of mortality, with about 20,550 estimated attributable deaths in 2012 and its incidence is increasing. Treatment of primary and secondary malignancies has evolved to include systemic, intra-arterial, as well as surgical options. In addition, patients with liver malignancies often have underlying steatosis, hepatitis, or cirrhosis. As such, a single-day multidisciplinary clinic in which patients can be seen by various providers during one visit may be of great benefit to patients with liver tumors. The multidisciplinary liver clinic (MDLC) at the Johns Hopkins Hospital (JHH) was established in 2009 to evaluate patients with liver tumors by a range of specialists within the same visit day and site. Patient assessment by our multidisciplinary liver clinic had a significant impact on their management, resulting in alterations in imaging and pathology interpretation, diagnosis, and management plan. The MDLC is an effective and convenient means of delivering expert opinion about the diagnosis and management of liver tumors. |
