VICS Optimal Care Summits pancreatic cancer consultation 2017

The first pancreatic cancer consultation by the VICS Optimal Care Summits program was held in 2017.

The consultation led up to a live summit event on 24 November 2017, with 70 multidisciplinary stakeholders from across Victoria.

Recommendations

The advisory group below recommended an audit of:

1. Patients who did not receive adjuvant therapy following pancreatic resection and the reasons for not receiving it
2. The statewide multidisciplinary meeting (MDM) capture rate for pancreatic cancer patients and the characteristics of patients not being discussed
3. The percentage of patients who had contact with a palliative care service and at what time point in the pathway of care.

Impacts

The recommendations above prompted a population-based analysis, by investigators from several VICS member health services, of treatment patterns and outcomes for pancreatic cancer in Victoria. Details and results of that analysis were published in ANZ J Surg. 2020 Sep;90(9):1677-1682. The study found that nearly a quarter of surgically treated patients never received systemic therapy and over two-thirds of non-metastatic patients never proceeded to surgery. The authors recommended further consideration of neoadjuvant therapy be given to borderline resectable patients.

Those insights informed a repeat pancreatic cancer summit in 2022 and a review of changes in pancreatic cancer care between 2016 and 2019. That review, published in ANZ J Surg. 2023 May 23, found surgical outcomes in Victoria remained world-class and there had been an appropriate shift in chemotherapy administration towards neoadjuvant timing with increasing use of fluorouracil (5FU)-based regimens. However, multidisciplinary meeting (MDM) presentation rates, supportive care, and overall care coordination remained “areas of deficiency”.

Consultation following this and later summits, with the Department of Health and Safer Care Victoria, identified the timeliness of advance care planning and referral to palliative care for people with metastatic cancer was identified as possible areas for improvement. The VICS undertook a scoping project to understand current practices relating to palliative care referral and advance care planning in Victoria. The final report from the project made 18 recommendations to address variations in the timing of access to palliative care and advance care planning, collection and storage of data, promotion of palliative care services, processes, models of care, and research and quality improvement activities.

Summit records

• Introduction presentation video
• Policy context presentation video
• Data presentation video
• Summit summary video
• Summit summary (PDF)
• Summit evaluation (PDF)

Expert advisory group

• Prof. Christopher Christophi (Co-chair) – Hepatopancreatobiliary (HPB) surgeon and Medical Director of Surgical Unit, Austin Health
• Mr Charles Pilgrim (Co-chair) – HPB surgeon, Alfred Health and Cabrini Health
• Dr Rob Blum – Medical oncologist, Bendigo Health
• Mr Dan Croagh – HPB surgeon, Monash Health
• Mr David Deutscher – Surgeon, Ballarat Health Services
• Mr Adrian Fox – HPB surgeon, St Vincent’s Hospital
• A/Prof. Peter Gibbs – Medical oncologist, Royal Melbourne Hospital (RMH) and Peter MacCallum Cancer Centre (Peter Mac.)
• Mr George Kalogeropoulos – Surgeon, Barwon Health
• Dr Richard Khor – Radiation oncologist, Austin Health
• A/Prof. Brian Le – Director of Palliative Care, RMH and Peter Mac.
• Dr Belinda Lee – Medical oncologist, RMH and Peter Mac.
• Mr Mehrdad Nikfarjam – HPB surgeon, Austin Health and Epworth Healthcare
• Dr Babak Tamjid – Medical oncologist, Goulburn Valley Health
• A/Prof. Niall Tebbutt – Director of Medical Oncology Unit, Austin Health
• A/Prof. Ben Thomson – Director of UGI tumour stream, RMH and Peter Mac.
• A/Prof. Valery Usatoff – Head of UGI unit, Western Health, Alfred Health and Cabrini Healthcare
• Prof. John Zalcberg – Medical oncologist and UGI cancer registry custodian, Monash University.