Characteristics of Patients Seeking Second Opinions at a Multidisciplinary Colorectal Cancer Clinic

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Diseases of the colon and rectum


BACKGROUND: Patients seeking second opinions are a challenge for the colorectal cancer provider due to complexity, failed therapeutic relationship with another provider, need for reassurance, and desire for exploration of treatment options.

OBJECTIVE: To describe the patient and treatment characteristics of patients seeking initial and second opinions in colorectal cancer care at a multidisciplinary colorectal cancer clinic.

DESIGN: Retrospective cohort study SETTINGS:: Prospectively collected clinical registry of a multidisciplinary colorectal cancer clinic.

PATIENTS: Patients with colon or rectal cancer seen from 2012-2017.

MAIN OUTCOME MEASURES: Data were analyzed for initial vs. second opinion and demographic and clinical characteristics.

RESULTS: Of 1711 colorectal cancer patients, 1008 (58.9%) sought an initial opinion, 700 (40.9%) sought a second opinion. As compared to initial opinion patients, second opinion patients were more likely to have Stage IV disease (OR 1.94, 95% CI 1.47-2.58), recurrent disease (OR 1.67, 95% CI 1.13-2.46), and be ages 40-49 (OR 1.47, 95% CI 1.02-2.12). Initial and second opinion cohorts were similar in terms of gender, race, and proportion of colon vs. rectal cancer. Among second opinion patients, 246 (35%) second opinion patients transitioned their care to the multidisciplinary colorectal cancer clinic.

LIMITATIONS: We were unable to capture final treatment plan for those patients who did not transfer care to the multidisciplinary colorectal cancer clinic.

CONCLUSIONS: Patients seeking a second opinion represent a unique subset of colorectal cancer patients. In general, they are younger, and more likely to have Stage IV or recurrent disease than patients seeking an initial opinion. Although transfer of care to a multidisciplinary colorectal cancer clinic after second opinion is lower than for initial consultations, multidisciplinary colorectal cancer clinics provide an important role for patients with complex disease characteristics and treatment needs. See Video Abstract at http://links.lww.com/DCR/B192.

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ePub ahead of print