1722P - Factors contributing to differences in evidence compliance rate in cancer treatment among second opinion cases

Background

Adherence to guidelines is linked to favorable prognosis in various cancer types. Nevertheless, the increasing complexity and sophistication of cancer drug therapy have posed challenges in identifying evidence-based treatment options. Thus, patients with cancer and local physicians are increasingly resorting to the cancer center's second opinion (SO) system for advice on treatment strategies. Integrating academic opinions from multiple physicians via SOs is expected to improve the evidence compliance rate (ECR). However, it remains unclear which cases would benefit from SOs to enhance the ECR. This study aimed to identify the factors contributing to the differences in ECR in patients with cancer.

Methods

A single-center retrospective study was conducted at the Department of Medical Oncology, National Cancer Center Hospital (Tokyo, Japan), analyzing electronic medical records of 305 patients with cancer who received SOs between January and June 2022. Two medical oncologists evaluated ECR according to the latest international standard guidelines for each cancer and classified them into two levels (Compliance: ECR is ≧50%, Non-compliance: ECR is <50%).

Results

Of 305 cases referred from 130 hospitals, 247 (81%) were female; the median age was 56 years (range: 15–85). Among them, 150 (49.2%)/152 (49.8%) were common/rare cancers, with 95 (31%) having gynecological cancers, 84 (28%) having breast cancers, and 66 (22%) having mesothelial and soft tissue cancers as major groups. After excluding cancer types for which no guidelines existed, 214 cases were eventually analyzed. Japan had a significantly higher ECR with designated core or designated hospitals for cancer genomic medicine (p=0.036). No significant relationship was found between ECR and hospital types, such as oncology, university, or urban hospitals. Moreover, no significant relationship was found between ECR and cancer types and who requested the SO.

Conclusions

This study highlights differences in ECR based on referral hospital type. The findings may aid in the appropriate allocation of medical resources between cancer centers and local hospitals as online medical care networks become more prevalent in the future.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.