ABSTRACT
In Spain, lung cancer (LC) is the fourth most common cancer. Managing LC involves different professionals, and cooperative and coordinated work is crucial. Therefore, important decisions are better made by Multidisciplinary Thoracic Tumour Boards (MTTBs). On the other hand, certification systems have proven to improve the structure of care, ultimately having a positive impact on patient survival. Herein, a multidisciplinary working group of 11 experts (a Radiologist, a Thoracic Surgeon, a Pulmonologist, a Radiotherapy Oncologist, four Medical Oncologists, a Hospital Managing Director, a Cytologist, and a Molecular Biologist specialist) proposed a standard to certify and evaluate MTTBs. The following components were suggested for the standard: minimum requirements for the MTTB, a mixed model developed in two stages (preparation and audit), a structure comprising three groups of indicators (Strategic and Management, Support, and Operational), three certification levels, and an audit process. In our opinion, certifying MTTBs is critical to improve the standard of care for LC patients.
ABSTRACT
Presentamos un caso que por sus connotaciones diagnósticas y terapéuticas resulta especialmente didáctico e ilustrativo, pues aborda el cómo, el quién y dónde debe realizarse la cirugía de cáncer de recto localmente avanzado. Ilustra el manejo diagnóstico y la estadificación del cáncer de recto en el momento actual. Este caso se aborda en el comité de forma multidisciplinar, y reúne los distintos avances en la cirugía de cáncer de recto de los últimos años (escisión total mesorrectal, abordaje laparoscópico, radioterapia intraoperatoria, resección perineal extendida, reparación del suelo pélvico con material protésico). Todo ello aunado a la opinión de que deben ser instituciones y grupos muy especializados y dedicados al tratamiento de esta patología los que deberían centralizar su atención médica.
We present a case, which due to its diagnostic and therapeutic connotations makes it especially educational, as it addresses the how, the who and where should the surgery be performed for locally advanced rectal cancer. It illustrates the diagnostic management and staging of rectal cancer at the present time. The case is approached in a multidisciplinary committee manner, and binds the various advances in surgery of rectal cancer in recent years (total meso-rectal excision, laparoscopy, intraoperative radiotherapy, extended perineal resection, pelvic floor repair with prosthetic material). This serves to underline the view that there must be highly specialized institutions and groups dedicated to the treatment of this condition in order to centralize its health care.