Optimizing disparities in time to treatment: A comprehensive multidisciplinary clinic.

Abstract

e13569 Background: Gastrointestinal (GI) cancer patients need personalized treatment plans often requiring a multimodal approach that includes surgery, radiation therapy, chemotherapy, and survivorship care. Health disparities in minority populations lead to additional hurdles in cancer care which a multidisciplinary clinic (MDC) can prevent with early treatment planning. We aim to evaluate if the GI MDC clinic established in an ethnically diverse area decreases the time to treatment and increases access of care to underserved communities. Methods: A retrospective analysis of a prospectively collected database was utilized for data collection in patients over 18 with a GI cancer diagnosis who visited the GI MDC clinic in Queens, New York. Over 100 demographic and clinical data points were collected on patients from 1/2024 to 12/2024. MDC patients (Group 1) were compared to a historical cohort of GI cancer patients treated within the health system that were not treated by the MDC (Group 2). Continuous variables were evaluated using Student’s t-tests and Wilcoxon rank-sum tests. Primary outcomes included time from referral to appointment and time from appointment to surgery/chemotherapy initiation. Results: The final cohort included 87 patients in Group 1. Average age was 66.8 ± 12.9, 48 (55.2%) were female, at least 35 (40.2%) were underrepresented minorities by race, and 60 (69.0%) lived in a zip code in the bottom 50% of the US by per capital income. Group 2 included 153 patients. The types of diagnoses are shown in Table 1. Most notably, Group 1 (n = 28) had significantly shorter times from appointment to neoadjuvant chemotherapy initiation (18.2 ± 15.4 vs. 49.3 ± 19.0, p < 0.001). Group 1 had a median time from appointment to surgery of 19 days (IQR = 20). In addition, the MDC offered each patient an average of nearly four appointments in their first visit on a single day including surgical oncology, medical oncology, radiation oncology, palliative care, advanced GI, and genetics. Conclusions: Our GI MDC model had early success in establishing multiple specialist appointments for underserved patients on a single visit. The utilization of this model has significantly reduced the time to initiation of neoadjuvant chemotherapy in GI cancer patients. In addition, this novel MDC model has allowed streamlining of complex cancer care in the diverse underserved population. Demographics and outcomes for GI MDC patients. Variable Group 1 (n = 87) Gastroesophageal Cancer Diagnosis by MDC, n, % 21 (24.2%) Hepatobiliary Cancer Diagnosis by MDC, n, % 20 (22.9%) Pancreatic Cancer Diagnosis by MDC , n, % 26 (29.9%) Colorectal Cancer Diagnosis by MDC , n, % 20 (22.9%) Time from Referral to MDC (days), mean ± SD 10.8 ± 11.8 Time from MDC to Surgery (days) 27.8 ± 20.0 Received Neoadjuvant Chemotherapy After MDC, n, % 28 (32.2%) Time from MDC to Neoadjuvant Chemotherapy (days) 18.2 ± 15.4 Number of Same Day Appointments Scheduled Through MDC 3.8 ± 1.2