Territorial Oncology L’Aquila ASL1 Abruzzo, Italy: 11 years of experience in a complex organization integrating innovative outpatient oncologic treatment and care models.

Abstract

e13582 Background: We report 11 years organization from 2014 and overall results of Oncology Territorial Care (OTC) Unit L’Aquila, Italy ASL1 Abruzzo, Innovative Strategic Project “Integrated Personalized and Territorial Oncology”, with primary aims of humanize and personalize oncologic cure and care, integrating territorial and hospital clinical activities. Methods: OTC Unit performs outpatient clinical activities (OCA) services (OS) at operative center, San Salvatore Hospital L’Aquila, consisting of Ambulatorial Oncologic Therapies (AOT), intravenous (PAC2) and non infusional (PAC1), out-patient visits (OV), specifically First Access (FA), Follow up (FU), Prevention and Cancer Predisposition (PreV), periodic on-/off-treatment (PV) settings, integrated with ASL1 Abruzzo Territorial Ambulatories (TA) in the Province of L’Aquila, since 2/2015 at L’Aquila, Avezzano, Sulmona health Districts, 9/2017 Tagliacozzo and 5/2018 Castel di Sangro territorial Hospitals. Oncologic clinical activities are also integrated with Multidisciplinary Oncologic Groups and Oncology Territorial Network (OTN), including Territorial General Medicine and Home Care, Health Residential Care, Palliative Care and Hospice. Results: From 10/2014 to 9/2025, overall 3610 patients were followed, prevalently affected by gastrointestinal cancer 47.3%, breast 14.5%, urologic 9.7%, gynecologic 5.9%, and 57661 OCA OS performed: OV 41065 (71.2%), prevalently FA 2564 (6.3%), PV 29796 (72.5%), FU 8493 (20.7%), PreV 212 (0.5%). From 8/2016, AOT, first Oncologic Unit in Abruzzo Region Italy, all prescribed and administered at operative center, were 16596 (28.8%), PAC2 13185 (79.4%), PAC1 3411 (20.6%). According to the sequential activation of TA in L’Aquila Province, overall 8869 (21.6%) territorial OV were performed, representing for each setting: FA 397 (4.5%), 15.5% overall FA; PV 909 (10.2%), 3% overall PV; FU 7399 (83.4%), 87.1% overall FU, at L’Aquila District 5125 (69.3%) and other territorial ambulatories 2274 (30.7%); PreV 164 (1.8%), 77.4% overall PreV. Conclusions: Complex organization of OTC L’Aquila Italy, dinamically integrating innovative outpatient oncologic treatment and hospital/territorial care models links AOT with territorial OV gaining overall 21.6%, according to patients’ home proximity, specifically for FU 87.1% overall (83.4% territorial OV), FA 15.5% overall (4.5% territorial OV), PV 3% overall (10.2% territorial PV) for management of metastatic chronic patients integrated with OTN, thus contributing to assure continuity and equity of access to oncologic cure and care, and public health sustainability; it will also integrate territorial OV specifically addressing oncologic clinical pathway, cancer predisposition/prevention, AOT/PAC1 non intravenous.