Optimising cancer care
Cancer Institute NSW
Published 6 July 2018
This is a state-wide initiative that aims to save more lives from cancer by using the latest evidence to inform how, when and where people receive cancer treatment.
To achieve this we use data to drive postitive change — working collaboratively across the health system to support improvements in cancer care.
Surgery is a common treatment for cancer. Cancer surgery encompasses a vast range of surgical procedures with varying degrees of complexity and associated risks. [1, 2]
The volume of surgeries that a hospital performs to treat different types of cancer is an important determinant of a person’s outcomes, especially for highly specialised procedures.
For people who require complex surgery, such as a pancreatectomy or oesophagectomy, it is better to have the procedure at a hospital that performs these often, and to have their care overseen by a team of cancer specialists who are experienced in this surgery - a multidisciplinary team (MDT). [3]
Strategic management of patient flows and referral pathways can optimise the number of surgeries being performed (caseload) locally, to allow centres to provide optimal care. Consolidation from several lower-volume hospitals within a LHD can help to deliver better cancer outcomes, including survival.Timely access to surgery can improve outcomes for some cancers, including lung, gastric and pancreatic cancer. [1, 4-6] Variations have been observed in Australia and internationally in the percentage of eligible people who receive surgery as the first treatment for their cancer, presenting an opportunity to increase resection rates and drive improvements in patient care. [1, 4-6, 7]
Bladder cancer specialist centres listed for Sydney and NSW regions
Complex head and neck cancer specialist centres listed for Sydney and NSW regions
Lung cancer specialist centres listed for Sydney and NSW regions
Women in NSW with ovarian cancer, cervical cancer and other gynaecological cancers should be assessed & treated at one of these 7 specialist gynaecological oncology centres.
People suspected of or diagnosed with oesophageal or gastric cancer in NSW should be referred to one of these specialist centres
People suspected of or diagnosed with pancreatic cancer, primary liver cancer, and cholangiocarcinoma in NSW should be referred to one of these specialist centres
Management of adult-onset sarcoma can be complex and requires a team of healthcare professionals with experience in sarcoma treatment
References
1. Currow DC, You H, Aranda S, et al. What factors are predictive of surgical resection and survival from localised non-small cell lung cancer? MJA. 2014;201(8):475–80.
2. Vinod SK, Sidhom MA, Gabriel GS, et al. Why do some lung cancer patients receive no anticancer treatment? J Thorac Oncol. 2010;5(7):1025–32.
3. Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med 2002;346:1128–37.
4. Riaz SP, Linklater KM, Page R, et al. Variation in surgical resection for lung cancer in relation to survival: population-based study in England 2004-2006. Eur J Cancer. 2012: 48(1):54-60.
5. Koppert LB, Lemmens VE, Coebergh JW, et al. Impact of age and co-morbidity on surgical resection rate and survival in patients with oesophageal and gastric cancer.Br J Surg. 2012 99(12):1693-700.
6. Creighton N, Walton R, Roder DM, et al. Pancreatectomy is underused in NSW regions with low institutional surgical volumes: a population data linkage study. Med J Aust. 2017 206(1):23-9.
7. Coupland VH, Lagergren J, Lüchtenborg M, Jack RH, Allum W, Holmberg L, Hanna GB, Pearce N, Møller H. Hospital volume, proportion resected and mortality from oesophageal and gastric cancer: a population-based study in England, 2004–2008. Gut. 2013;62(7):961–6.