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Purpose <p>Second opinions are increasingly sought by patients, particularly in complex and life-altering conditions such as gastrointestinal (GI) cancers, to ensure confidence in their diagnosis and treatment plans or to seek therapeutic trials.</p> Methods <p>This retrospective study analyzed second-opinion requests handled by the GI oncology team in our institution between January and March 2024, examining the types of questions raised, patient characteristics, and their impact on clinical decision-making.</p> Results <p>Of 261 eligible patients, 259 were included in this analysis. Most patients had metastatic disease (86%), and 51% had received at least two lines of prior treatment. Requests were predominantly submitted by oncologists (63%), with a significant proportion (41%) coming from outside academic centers. General practitioners (GPs) accounted for 37% of the submissions, often with incomplete records (86% completeness vs. 99% for oncologists; <i>p</i> &lt; 0.01). The median age at diagnosis was 60&#xa0;years, with younger patients being more frequently referred by oncologists (57.0 vs. 62.5&#xa0;years, <i>p</i> &lt; 0.001). The most common diagnoses were pancreatic (29%) and colorectal (27%) cancers. Second-opinion requests focused on therapeutic management (73%) and access to clinical trials (60%). Therapeutic decisions were in line with the standard of care in 93% of the cases, while 15% received alternative recommendations, such as intrahepatic arterial infusion or targeted therapies. However, participation in therapeutic trials (1.2%) and molecular screening (2.7%) was seldom offered to patients, highlighting the need for better tools to access trials. Importantly, palliative care decisions were upheld in 95% of the specific requests.</p> Conclusion <p>This study demonstrates the potential value of structured second-opinion pathways in ensuring adherence to evidence-based care and addressing patient concerns. However, improving GP support, reducing referral delays, and optimizing access to trials remain critical for improving outcomes in patients with advanced GI cancer.</p>

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Impact of oncology review meetings on second opinions for patients with gastrointestinal cancer

  • 期刊论文

  • 发表日期：

    2025年9月20日

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  • Marc Nourrit,
  • Géraldine M. Camilleri,
  • Anne-Claire Couderc,
  • Audrey Verchain,
  • Kamilia Bouatay,
  • Marine Valéry,
  • Cristina Smolenschi,
  • Antoine Hollebecque,
  • Thomas Pudlarz,
  • Alexandre Megherbi,
  • Laura Diebakate,
  • Matthieu Delaye,
  • Mohamed Khettab,
  • Valérie Boige,
  • Michel Ducreux,
  • Alice Boilève

摘要

Purpose

Second opinions are increasingly sought by patients, particularly in complex and life-altering conditions such as gastrointestinal (GI) cancers, to ensure confidence in their diagnosis and treatment plans or to seek therapeutic trials.

Methods

This retrospective study analyzed second-opinion requests handled by the GI oncology team in our institution between January and March 2024, examining the types of questions raised, patient characteristics, and their impact on clinical decision-making.

Results

Of 261 eligible patients, 259 were included in this analysis. Most patients had metastatic disease (86%), and 51% had received at least two lines of prior treatment. Requests were predominantly submitted by oncologists (63%), with a significant proportion (41%) coming from outside academic centers. General practitioners (GPs) accounted for 37% of the submissions, often with incomplete records (86% completeness vs. 99% for oncologists; p < 0.01). The median age at diagnosis was 60 years, with younger patients being more frequently referred by oncologists (57.0 vs. 62.5 years, p < 0.001). The most common diagnoses were pancreatic (29%) and colorectal (27%) cancers. Second-opinion requests focused on therapeutic management (73%) and access to clinical trials (60%). Therapeutic decisions were in line with the standard of care in 93% of the cases, while 15% received alternative recommendations, such as intrahepatic arterial infusion or targeted therapies. However, participation in therapeutic trials (1.2%) and molecular screening (2.7%) was seldom offered to patients, highlighting the need for better tools to access trials. Importantly, palliative care decisions were upheld in 95% of the specific requests.

Conclusion

This study demonstrates the potential value of structured second-opinion pathways in ensuring adherence to evidence-based care and addressing patient concerns. However, improving GP support, reducing referral delays, and optimizing access to trials remain critical for improving outcomes in patients with advanced GI cancer.