TO better treat liver tumors in all the Marche, the doctors of the multidisciplinary teams meet (also) virtually, thanks to the telemedicine platform of the Oncology and Research Center of the Marche (CORM): a tool that can be used by all clinicians in benefit of patients, thanks to the sharing of the Diagnostic-Therapeutic-Assistance Path (PDTA). It is discussed today at the conference dedicated to hepatocellular carcinoma, taking place at the Teatro delle Muse in Ancona.
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“For the treatment of hepatocellular carcinoma we have new therapies available, but the real revolution lies in the multidisciplinary management of patients, which represents the most effective tool we have available today to reduce the mortality of this neoplasm”, says Rossana Berardi, Full Professor of Oncology of the Polytechnic University of Marche and Director of the Oncology Clinic of the Ospedali Riuniti of Ancona and National Councilor of Aiom (Italian Association of Medical Oncology). Depending on the characteristics of the patient and the tumor, in fact, the strategies can be different, and more than one treatment can be received. “We must establish a real therapeutic project, which is identified already at the time of diagnosis in specific meetings. The secret of the patient’s recovery is precisely the multidisciplinarity, as happens at the Ospedali Riuniti of Ancona thanks to the constant collaboration between hepatologists, surgeons, radiologists, and oncologists. Today this is also possible through the CORM telemedicine platform “.
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The platform for the management of health “commuters”
Not only. At the Ospedali Riuniti in Ancona, about 300 patients with focal liver lesions are evaluated every year, and in more than half of the cases they have cancer. Of these, 30% come from outside the Region. For all of them there is the problem of remote evaluation, as long as possible, to avoid tiring and expensive travel. This is another example of how technology, and in particular CORM’s telemedicine platform, can help.
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The importance of networking
In the Marche region, an oncological network involving many different disciplines is growing more and more: “The results are tangible especially in diseases such as primary liver tumors, which unfortunately show a significant increase in the incidence in all Western countries”, underlines Filippo Saltamartini, Councilor for Health of the Marche Region: “We are working, as a Region, to consolidate the most advanced experiences. Like the CORM, which also represents the virtual network that allows the sharing of the best patient care pathway between all the oncologies of the Marche region, specialists and general practitioners “.
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PDTA first
In this scenario, regional PDTAs are today an indispensable tool. “We work as the Health Department of the Marche Region to strengthen the efficiency and effectiveness of clinical networks and the regional PDTAs must form the fabric of the new healthcare, so as to act more appropriately towards a digital future which, through the new law and the new Social-Health Plan, meet the health needs of the population ”, adds Armando Gozzini, director of the Health Department of the Marche Region.
The PDTAs of Ospedali Riuniti have for some years been the basis of the quality certification (ISO 9000-vision 2015) which in Italy has been issued, at the level of the entire organization, only at the AOU Ospedali Riuniti, underlines Michele Caporossi, Director General of the ‘Institute. Now, the PDTA for hepatocellular carcinoma is also added: “It is the result of a precious team work and, thanks to the CORM platform, it becomes an instrument of the entire oncology network of the Marche region. The network will allow us to make a decisive contribution to the fight against this neoplasm and to propose advanced know-how for many other pathologies “.
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Yes, because complex pathologies such as primary liver tumors require adequate expertise and training: “A valid disciplinary, basic and specialized training and the ability to work in teams are important objectives of the university path of the Faculty of Medicine and Surgery of the Polytechnic University delle Marche, in order to support interdisciplinary work in health ”, specifies Mauro Silvestrini, Dean of the Faculty of Medicine and Surgery of the Polytechnic University of Marche.
What does “early diagnosis” mean
In addition to treatment, prevention must not be forgotten, which has a central role: we must be aware that all patients with liver damage must be evaluated by a specialist to define the degree of such damage “, explains Gianluca Svegliati Baroni, Associate Professor in Gastroenterology of the ‘Polytechnic University of Marche and Head of the Liver Damage and Transplantation Unit at the Ospedali Riuniti of Ancona: “All patients with or at risk of cirrhosis must screen for an early diagnosis, based on a simple ultrasound, to be done every six months. This is the first aspect to underline of our PDTA. The next step in the early diagnosis of the tumor, in the presence of a suspicious picture on the ultrasound of the abdomen, is the execution of second level radiological investigations (CT or Magnetic Resonance, ed.) Which in expert hands allow to arrive at a definitive diagnosis and therefore to identify the treatment options for each individual case “.
13,000 diagnoses a year
Prevention, early diagnosis and multidisciplinarity are therefore the three keywords in the fight against hepatocellular carcinoma, which affects 13 thousand people in Italy every year, and which unfortunately still has a low survival (20% at 5 years and 10% at 10 years). Among the speakers of the conference, which today deals with the many aspects of this pathology, there are also Roberto Papa, expert in methodology in the preparation of the PDTA, Marco Vivarelli, Director of the Clinic of Hepatobiliopancreatic Surgery and Liver Transplantation, Andrea Giovagnoni, Director of the Clinic of Radiology, Roberto Candelari, Director of Interventional Radiology, Lorenza Rimassa of the Humanitas Institute of Rozzano and Fabio Piscaglia of the University of Bologna.