PO178 Presenting features, referral pathways, and waiting times for patients with glioblastoma multiforme: a retrospective cross-sectional analysis

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Abstract

Glioblastoma multiforme (GBM) is a highly malignant form of glioma with a universally poor prognosis, despite advances in treatment and the introduction of national cancer waiting time targets. We collected data for all cases diagnosed locally between 2009–2016, including clinical features, referral route, and mortality. Timelines for discussion, investigation and treatment were constructed for each patient, and compared for evidence of variation in care based on referral route. Of 58 cases, A and E presentations accounted for 69%, followed by non-urgent GP referrals (19%) and 2-week-wait referrals (9%). Presenting symptoms were highly variable and included headache, weakness, seizures, and cognitive deficits. There was no difference in waiting time to first specialist discussion, biopsy, or treatment between A and E and 2-week-wait cases. Non-urgent referrals experienced longer waits for specialist discussion (p=0.037) and biopsy (p<0.001). However, this had no impact on time to treatment or on 1, 3, or 5 year survival. Our study shows that the majority of patients with high-grade gliomas are not detected via the 2-week-wait system, and that referral route has a negligible impact on patient care. This highlights significant human and financial resources that could be more productively deployed elsewhere, and the need for more effective strategies of referral and investigation.

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