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Clinical pathways in gastric cancer care

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Abstract

The diagnostic–therapeutic pathways (DTPs) are emerging as useful instruments for clinical management of complex diseases as gastric cancer, whose treatment is challenging and requires a multidisciplinary approach. However, the DPTs of patients with gastric cancer are still not defined yet. The aim of this study was to define the optimal DPT to be applied for patients with gastric cancer in the Veneto region. Rather than defining the ideal DTPs a priori, we conducted a preliminary research by analyzing the differences in the actual DPTs for patients with gastric cancer among different hospitals (hub and spokes) in Veneto. Then, the final DPT was elaborated based on the current available best clinical evidences; however, also the areas of homogeneity among the actual DPTs of the included centers as well as the critical issues that had emerged by our preliminary analysis were taken into account for pathway design. High heterogeneity in actual DTPs of patients with gastric cancer was observed among the analyzed centres. Moreover, some of the major criticisms have been found at crucial points of the current pathways. Based on these data, a reference path that is applicable to the whole-regional health network was constructed. The reference DTP is focused on multidisciplinary team management of patients with gastric cancer. Clinical pathways are essential tools to properly manage complex diseases such as gastric cancer. As such, more efforts should be done to implement their use.

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Acknowledgements

Roberto Merenda (Venice City Hospital); Donato Nitti (Padova University Hospital); Cristina Oliani (Hospitals of Montecchio Maggiore and Arzignano); Felice Pasini (Rovigo Hospital); Vittorina Zagonel (Veneto Institute of Oncology) are greatly acknowledged.

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Authors and Affiliations

  1. General and Upper GI Surgery Division, University of Verona, Piazzale Aristide Stefani 1, 37126, Verona, Italy

    Maria Bencivenga, Lorenzo Scorsone, Valentina Mengardo & Giovanni de Manzoni

  2. Istituto di Management, Scuola Superiore Sant’Anna, Pisa, Italy

    Ilaria Palla & Giuseppe Turchetti

  3. Istituto Oncologico Veneto, Padua, Italy

    Alberto Bortolami

  4. Unit of Oncology, Verona University Hospital, Verona, Italy

    Michele Pavarana

Authors
  1. Maria Bencivenga
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  2. Ilaria Palla
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  3. Lorenzo Scorsone
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  4. Alberto Bortolami
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  5. Valentina Mengardo
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  6. Michele Pavarana
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  7. Giuseppe Turchetti
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  8. Giovanni de Manzoni
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Corresponding author

Correspondence to Maria Bencivenga.

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All authors declare that they have no conflict of interest.

Research involving human participants and/or animals

The research does not involve human participants and/or animals.

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Additional information

This study belongs to the Program for Research, Innovation and Health Technology Assessment (PRIHTA) of Veneto Region and has been founded by Ely Lilly.

The article is part of topical collection on Gastric Cancer Surgery.

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Bencivenga, M., Palla, I., Scorsone, L. et al. Clinical pathways in gastric cancer care. Updates Surg 70, 279–291 (2018). https://doi.org/10.1007/s13304-018-0544-2

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  • DOI: https://doi.org/10.1007/s13304-018-0544-2

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