gms | German Medical Science

Introduction: The clinical management of advanced gynaecological malignancies requires multimodal and interdisciplinary strategies. Participation in clinical trials is also part of the state of the art therapy of gynaecological cancer. The logistical requirements of classical tumor conferences (i.g. long distance) are limiting factors for many physicians and general practitioners. Therefore we have established an online tumor conference using internet and systematic approach discussing case reports based on national (AGO) and international guidelines (ASCO, NCI), systematic review of literature and possibilities for study entry. This network consisting a panel of various disciplines (gynaecologists, surgeons, urologists, radiologists, oncologists and 30 gynaecological and oncological practitioners).

Methods: The innovative concept of the first online tumor conference was established in November 2004 as a pilot project of integrated health care. The management of the case reports includes short presentation of the patient casuistic with surgical and systemic therapy, histology, X-ray, Scan and other paraclinic results, performance status and patients preferences to therapy. For each case report an individualized overview of the therapy-guidelines of AGO, ASCO, NCI as also a review of open clinical trials is presented. After expert discussion an individual recommendation for diagnostic and therapy for each patient is formed, as also submission for treatment in open clinical trials. Case report protocols are done and send to all of the participants.

Results: In a range of 12 months 21 conferences were performed with more than 95 discussed patient cases with following diagnoses: ovarian cancer 42%, cervical cancer 15%, endometrial cancer 12%, mullerian mixed tumors 5% and other tumor cases 26%. More than 500 participants take part and more than 100 second-opinions were evaluated. In an anonymous inquiry most of the participants are satisfied with the information content (84%), technical and logistical support (72%), and the improvement of quality of care was improved (67%). The compliance rate of the recommendations of the conference is high (90%).

Conclusion: The concept of online tumor conference is feasible and can be easy integrated into the clinical day. This concept can potentially improve the implementation of guidelines, the rate study participations and clinical care.

Supported by Amgen, GlaxoSmithKline, Medac