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Cancer Registration Oncology Team Tulip Integrated Cancer Clinic Dr Sardjito General Hospital.

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Presentation on theme: "Cancer Registration Oncology Team Tulip Integrated Cancer Clinic Dr Sardjito General Hospital."— Presentation transcript:

1 Cancer Registration Oncology Team Tulip Integrated Cancer Clinic Dr Sardjito General Hospital

2 TULIP integrated cancer clinic Funded by Dutch Cancer Foundation (KWF) Operated since 2001 Service: adult oncology cases. Multi-disciplinary approach.

3 Number of cancer visits

4 Top 5 visits in 2012

5 Oncology management still spreads in separated units Radiodiagnostics Radiotherapy Chemotherapy in general wards and one day care Tulip Dx Lab and supports Pathology, Molecular biology, immunology, clinical chemistry, cytogenetics Cancer clinic Other clinics (departs of surgery, gynaecology, ENT, pulmonology, etc) Surgery First visit Diagnostic Treatment

6 Tulip cancer clinic and radiotherapy have particular medical records

7 Background Cancer registration has not been comprehensively done. Systematic collection of data for every cancer patient have not been registered well. Bottleneck includes – commitment to persist the work – lack dedicated person in doing documentation – financial support Lack information to support policy in improving cancer management. A small registration has been started in Tulip.

8 Tulip cancer registration It started in 2012. Research intention. Aim: – cancer incidence – success of treatment – comparison of available treatment to the standard, treatment modalities Case report form – based. Involves data from 2007-2011 on 4 cancer types: – Breast cancer - Colorectal cancer (CRC) – Nasopharyngeal cancer (NPC) - Multiple myeloma (MM) Principle: starts small and grows. Other types of cancer will be registered as well.

9 (Non-official) organization Head of subdepart of hematology and medical oncology Data coordinator - CRC (subspecialty fellow) Data coordinator - MM (subspecialty fellow) Data coordinator - NPC (subspecialty fellow) Data coordinator – breast ca (subspecialty fellow) Data manager - CRC Research assistant Data manager – NPC Research assistant Data manager – MM Research assistant Data manager – Breast Research assistant Head of Tulip cancer clinic

10 Items on Case Report Form Demography (Patients Initial, Patients Code, Tulip/RSUP Dr. Sardjito MR, Date of Birth, Age, Address, Contact Number, Address Type, Sex, Occupation, Education Level, Funding, Risk Factors, Past History) Diagnosis (Visit Type, Chief-complaint, Early Sign, First Party Treating Chief-complaint, Chief-complaint to Medical-attention Period, Early-detection to Surgery Period, Surgery to Chemotherapy Period, Early-detection, Additional Tests, Performance Status, Clinical Diagnosis, Pathological Diagnosis) Therapy (Surgery, Chemotherapy, Radiotherapy, Additional Tests, Toxicity) Post-therapy Monitor (Treatment Response, Event) Second-line therapy* (Indication, Type, Regimen, Start Date, End Date, Duration, Cycle, Additional Tests, Toxicity) Post-Second Line Therapy Monitor (Treatment Response) Consecutive Therapies Follow-up (Latest Follow-up Date, Final Status, Overall Survival, Disease Free Survival, Progression Free Survival) Other Analysis (Metastasis, Biomarkers, Comorbidity)

11 Flow of data collection Medical Record (Tulip Integrated Cancer Clinic) Medical Record (RSUP Dr. Sardjito) Case Report Form Excell database SPSS Analysis Data verification and exclusion Data completion and verification

12 Interim results

13 Number of cases of the 4 cancer types 387 8 38 57 9 59 88 65 18 70 17 42 57 20

14 Age distribution (breast ca)

15 Age distribution (CRC)

16 Age distribution (NPC)

17 Age distribution (MM)

18 Sex distribution

19 Histology grading (breast cancer)

20 Histology grading (CRC)

21 Histology grading (NPC)

22 Treatment modality (Breast cancer)

23 Treatment modality (CRC)

24 Treatment modality (NPC)

25 Treatment modality (MM)

26 Overall survival (CRC)

27 Overall survival (NPC)

28 Data of CRC on SRiKanDi (n= 173)

29 CRC on SRiKanDi (topography)

30 Data of CRC on SRiKanDi (morphology)

31 Challenges MR searching – Often takes days to find and get them ready for data entry Incomplete information (either in Tulip or central MR) Data discordance Loss to follow up needs mail and call checking. Registration technical trainings Multiple data sources Funding and organization

32 Can we set up such organization? RSKN Dharmais (1996-now)

33 Further steps Consolidation with other departments (Indonesian society of oncologist, Yogyakarta branch) – Surgeon (oncology surgeon) – Radiology (diagnostic and radio-oncology) – Pathology – Pediatric – Etc Study on data collection and administration in order to perform hospital-based cancer registration (Guardian YS, MD, MHealthinfo) Trainings Set up organization Learn from other centers (Dharmais, overseas) Fund raising (self-funded grant attract)

34 Acknowledgement Data coordinator Susanna H. Hutajulu, MD, PhD (Internist) Mardiah Suci H, MD, PhD (Internist) Femiko Mora, MD (Internist) Suryo A Taroeno, MD (Internist) Project leader Johan Kurnianda, MD (hematologist-medical oncologist) Data manager Wahyu Wulaningsih, MD, MRes. Naomi Yoshuantari, MD Zulrahman, MD Sri Wahyuni, Public health Multidisciplinary oncology team for cancer registry Artanto, MD (oncology surgeon) Wigati D, MD (radio-oncologist) Retno Dwi D, MD, (radio-oncologist) Henry Kusumo, MD (radiologist) Lina Choridah, MD (radiologist) Ediati, MD (pathologist) Ghozali, MD (pathologist) Eddy Supriyadi, MD, PhD (pediatrician, oncologist) Nungki Anggorowati, MD, PhD (pathologist) Bambang Hariwiyanto, MD, PhD (ENT oncologist) Sagung Rai Indrasari, MD (ENT oncologist) Camelia Herdini, MD (ENT oncologist) Burham W., MD (gynaecology oncologist) Lutfan Lazuardi, MD, PhD (health informatics) Guardian Y S, MD, MHealthinfo (health informatics) Fatwasari Tetra Dewi, MD, PhD Etcs. Steering committee Teguh Aryandono, MD, PhD, Prof. (oncology surgeon) Kartika Widayati, MD – Head of Tulip clinic (hematologist-medical oncologist) Ibnu Purwanto, MD (hematologist-medical oncologist) Kunta Setiaji, MD – Chief of cancer committee (oncology surgeon)

35 Data of CRC on SRiKanDi (ICD 10)

36 Overall survival (Breast cancer)

37 Overall survival (MM)

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