1. Pathway for patients with suspected HPB Cancer Inter Provider Transfer
Maximum Wait (Days)
Pathway for patients with suspected HPB Cancer
Provide information and psychological support throughout the patient journey
Referral received in secondary care
10 Days
Clinical history
Physical examination
Abdominal ultrasound
Imaging of the chest
First Seen
Rapid specialist assessment & one stop diagnostic service 10
Holistic assessment and AHP rehabilitation consideration CT
ERCP +/- biopsy
Further diagnostic investigations as indicated
Allocate HPB CNS
16-18 years old – refer to Paediatric Oncology (GNCC) for treatment and TYA MDT for discussion
19-24 years old – continue on tumour site specific pathway & refer to TYA MDT for discussion.
Is HPB cancer still suspected? No
Manage as appropriate and remove from cancer pathway
Inform patient's GP of serious diagnosis
See TYA pathway
Yes
Is patient to be managed locally, has tissue diagnosis been confirmed
See HPB Rehabilitation Care Pathway liaise & involve healthcare professionals as required No
Yes
15 Days
Inter Provider Transfer
Network Best Practice
Specialist MDT to discuss treatment & rehabilitation
plan
Link with specialist MDT
Consideration for clinical trial
Local MDT
discussion 25
6 Days CT
MRI
PET Scan
EUS +/- biopsy
Laparoscopy +/- biopsy
ERCP +/- biopsy
Staging Investigations as
indicated
Agree proposed treatment
plan with patient
Agree proposed treatment
plan with patient
Decision to treat 31
21 Days
Surgical
resection
Best Supportive Care
Radiotherapy
Chemotherapy
First Treatment 62
Specialist MDT to review treatment and rehabilitation plan plus consideration for clinical trials
Is further
treatment
Required?
Earliest Clinical Appropriate Date
for commencement of subsequent treatment
Yes
ECAD date No
Appropriate
after care
HPB Cancer Pathway