1. AUDIT OF COMPLIANCE WITH NHSCSP GUIDELINES REQUIRING MDT REVIEW OF ALL CERVICAL CANCER PATIENTS Dr. M Bhattacharjee Dr. A Mutton Dr. S Nagarajan

2. Objective To ascertain whether the Histopathology of all cervical cancer patients was discussed at the Gynaecology MDT as per NHSCSP guidelines.

3. Methods. A retrospective computer (SNOMED) search of the pathology database was performed to identify all cervical cancer histological specimens reported during a one year period between January and December 2011. Those biopsies reported in unit hospitals outside South Tees Trust were not included.

4. Cont. Departmental protocol dictates supplementary report to be issued on every case reviewed at the MDT. Among these, cases with supplementary report were identified.

5. Cont. In those without supplementary reports, the MDT co-ordinator’s record was used to ascertain whether they had been discussed at the MDT. The cases were further analysed on the basis of other parameters such as specimen type and the type of cancer.

6. Results. Total number of specimens – 51. Total number of patients – 41.

7. Results Types of specimen: Cervical punch biopsy – 12 (23.5%). Cervical LLETZ biopsy – 22 (43.1%). Radical hysterectomy – 16 (31.5%). Endometrial fluid – 1 (1.9%).

8. Types of specimen

9. Histological Tumour Types. Squamous cell carcinoma – 39. Adenocarcinoma – 10. Poorly differentiated carcinoma – 2.

10. Histological Tumour Types.

11. Results 31 patients had a FIGO stage. Of them 12 (39%) – 1A1 16 (52%) – 1B1 1 (3%) - 1B2 2 (6%) - 2A

12. Results Out of the 22 LLETZ biopsies 3 had no residual tumour in the subsequent hysterectomy specimen. Of them 1 was FIGO stage 1A1 2 were FIGO stage 1B1

13. MDT Review. Out of the 51 specimens: 49 specimens (96.1%) had a supplementary report sequence 2 in the pathology database to indicate MDT review. 2 specimens (3.9%) had no supplementary report in the pathology database.

14. MDT Review. MDT co-ordinator contacted to verify information on these 2 cases. –One was a private case and opted to shift region for treatment. –The other had been discussed at the MDT according to the MDT co-ordinator’s records. Therefore in reality all patients (100% compliance) were discussed at the MDT.

15. Conclusions. Out of a total of 41 patients with cervical cancer, 40 were discussed at the MDT (one patient opted to shift region). 1 patient (2%) had no supplementary report sequence 2 but had been discussed at the MDT (confirmed by the MDT co- ordinator).

16. Conclusions. Of the cervical cancers during the study period, 76% were squamous cell carcinomas, 20% were adenocarcinomas and 4% were poorly differentiated carcinomas. This is broadly in line with the relative incidence of the different histological types of cervical cancer

17. THANK YOU.