ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025
Impact of oncology review meetings on second opinions for patients with gastrointestinal cancer.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSecond opinions are increasingly sought by patients, particularly in complex and life-altering conditions such as gastrointestinal (GI) cancers, to ensure confidence in their diagnosis and treatment plans or to seek therapeutic trials.
methodsThis retrospective study analyzed second-opinion requests handled by the GI oncology team in our institution between January and March 2024, examining the types of questions raised, patient characteristics, and their impact on clinical decision-making.
resultsOf 261 eligible patients, 259 were included in this analysis. Most patients had metastatic disease (86%), and 51% had received at least two lines of prior treatment. Requests were predominantly submitted by oncologists (63%), with a significant proportion (41%) coming from outside academic centers. General practitioners (GPs) accounted for 37% of the submissions, often with incomplete records (86% completeness vs. 99% for oncologists; p < 0.01). The median age at diagnosis was 60 years, with younger patients being more frequently referred by oncologists (57.0 vs. 62.5 years, p < 0.001). The most common diagnoses were pancreatic (29%) and colorectal (27%) cancers. Second-opinion requests focused on therapeutic management (73%) and access to clinical trials (60%). Therapeutic decisions were in line with the standard of care in 93% of the cases, while 15% received alternative recommendations, such as intrahepatic arterial infusion or targeted therapies. However, participation in therapeutic trials (1.2%) and molecular screening (2.7%) was seldom offered to patients, highlighting the need for better tools to access trials. Importantly, palliative care decisions were upheld in 95% of the specific requests.
conclusionThis study demonstrates the potential value of structured second-opinion pathways in ensuring adherence to evidence-based care and addressing patient concerns. However, improving GP support, reducing referral delays, and optimizing access to trials remain critical for improving outcomes in patients with advanced GI cancer.
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