Shared care by paediatric oncologists and family doctors for long-term follow-up of adult childhood cancer survivors: a pilot study


Lancet Oncology 2008; 9:232-238

DOI:10.1016/S1470-2045(08)70034-2

Articles

Dr Ria Blaauwbroek MD email address a Corresponding Author Information,   Wemke Tuinier RN a,   Prof Betty Meyboom-de Jong PhD b,   Prof Willem A Kamps PhD a   and   Aleida Postma PhD a

Summary

Background

Since 75% of children with cancer will become long-term survivors, late effects of treatment are an ever increasing issue for patients. Paediatric oncologists generally agree that cancer survivors should be followed up for the remainder of their lives, but they might not be the most suitable health-care providers to follow up survivors into late adulthood. We designed a 3-year study to assess whether shared-care by paediatric oncologists and family doctors in the long-term follow-up of survivors of childhood cancers is feasible, whether a shared-care model is compatible with collection of data needed for registration of late effects, and how a shared-care model is assessed by survivors and family doctors.

Methods

In 2004 and 2005, adult survivors of childhood cancers were randomly chosen from eligible patients diagnosed with childhood cancer (excluding CNS tumours) or Langerhans-cell histiocytosis between January, 1968, and December, 1997, and recalled to the long-term follow-up (LTFU) clinic at the University Medical Centre Groningen, Groningen, Netherlands, where they underwent physical and clinical assessments by an on-site family doctor (visit 1). At this visit, assessments were done according to guidelines of the UK Children’s Cancer Study Group Late Effects Group, and late effects were graded by use of Common Terminology Criteria for Adverse Events (version 3). Follow-up assessments were done 1 year later in 2005 and 2006 by local family doctors (visit 2), who were asked to return data to the LTFU clinic. At this visit, the local family doctors were asked to complete a three-item questionnaire and patients were asked to complete a seven-item questionnaire about their satisfaction with the shared-care model. At the next consultation, which was planned for the end of the study (visit 3), the on-site family doctor advised patients about future follow-up on the basis of their individual risk of late effects. Main endpoints were numbers of participants, satisfaction ratings, and proportions of local family doctors who returned data that they obtained at visit 2 to the LTFU clinic.

Findings

133 individuals were chosen at random from 210 enrolled adult survivors. 123 of 133 (92%) randomly selected survivors and 115 of 117 (98%) of their family doctors agreed to participate in the share-care programme. 103 of 115 (90%) family doctors returned data to the LTFU clinic at visit 2. 89 of 101 (88%) of survivors were satisfied with this shared-care model, as were 94 of 115 (82%) family doctors; 18 of 115 (16%) family doctors had no views either way; and three of 115 (3%) family doctors were dissatisfied.

Interpretation

Shared-care by paediatric oncologists and family doctors is feasible for long-term follow-up of adult survivors of childhood cancers.

Affiliations

a. Department of Paediatrics, Division of Paediatric Oncology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
b. Department of General Practice, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands

Corresponding Author InformationCorrespondence to: Dr Ria Blaauwbroek, Department of Paediatrics, Division of Paediatric Oncology, University Medical Centre Groningen, University of Groningen, 9700 RB Groningen, Netherlands

Atlas de procedimientos en ginecologia oncologica


Atlas of Procedures in Gynecologic Oncology
By Douglas A. Levine, Richard R. Barakat, William J. Hoskins

  • Publisher: Informa Healthcare
  • Number Of Pages: 288
  • Publication Date: 2003-05-01
  • ISBN-10 / ASIN: 184184196X
  • ISBN-13 / EAN: 9781841841960
  • Binding: DVD

Book Description:

Expert practitioners at one of the world’s leading cancer centers have here collaborated on a practical guide to the procedures involved in gynecologic oncology. They explain the latest developments in both open and minimally invasive surgery. All the requisite procedures are comprehensively profiled, including cytoreduction, pelvic extenteration, brachytherapy and other treatments. The procedures are explained step-by-step and fully illustrated, with 800 color photographs. An accompanying CD-ROM provides over one hour of video clips with spoken commentary. Atlas of Procedures in Gynecologic Oncology is indispensable for clinicians and students in oncology and gynecology.

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Bibilioteca Virtual: Oncologia Pediatrica basada en la evidencia


Publisher:   Blackwell Publishing Limited
Number Of Pages:   576
Publication Date:   2007-04-01
Sales Rank:   887312
ISBN / ASIN:   1405142685
EAN:   9781405142687
Binding:   Hardcover
Manufacturer:   Blackwell Publishing Limited
Studio:   Blackwell Publishing Limited
Evidence-based Pediatric Oncology is a ground breaking text on the management of childhood cancers. Using evidence-based treatment recommendations from available systematic reviews and Standard Options Recommendations (SORs), it covers the range of tumour types occurring in children and young adults with recommendations for optimum treatments for childhood cancer.Offering reviews and commentaries from leading internationally recognised pediatric oncologists, this second edition now covers significant randomized controlled trails.

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