Abstract:
The term non-melanoma skin cancer (NMSC) refers to skin cancer different from melanoma, and it is usually restricted to basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and their pre-cancerous lesions, e.g., actinic keratosis. These conditions represent the most frequent tumors in Caucasians and are characterized by an increasing incidence worldwide and a high socio-economic impact. The term Integrated Care Pathway (ICP) refers to \"a complex intervention for the mutual decision making and organization of care processes for a well-defined group of patients during a well-defined period\". The purpose of this paper is to present a proposal from the Italian Association of Hospital Dermatologists (ADOI) for an ICP organization of care of NMSC, considering the hub-and-spoke model in the different geographical areas. This proposal is based on the most recent literature and on documents from the Italian Association of Medical Oncology (AIOM), the European consensus-based interdisciplinary guidelines from the European Association of Dermato- Oncology (EADO), and the National Comprehensive Cancer Network (NCCN). We initially discuss the NMSC outpatient clinic, the role of the multidisciplinary working groups, and the hub-and-spoke model regarding this topic. Then, we define the ICP processes specific for BCC and SCC. The ICP for NMSC is an innovative strategy to guarantee the highest possible quality of health care while the hub-andspoke model is crucial for the organization of different health care structures. Considering the importance on this topic, it is essential to create a valid ICP together with an efficient organization within the different geographical areas.
摘要:
术语非黑色素瘤皮肤癌(NMSC)是指不同于黑色素瘤的皮肤癌,它通常仅限于基底细胞癌(BCC),鳞状细胞癌(SCC)及其癌前病变,例如,光化性角化病。这些病症代表白种人中最常见的肿瘤,并且特征在于全球发病率增加和高社会经济影响。综合护理路径(ICP)一词是指“在明确定义的时期内,对明确定义的一组患者进行相互决策和组织护理过程的复杂干预”。本文的目的是提出意大利医院皮肤科医师协会(ADOI)关于NMSC护理ICP组织的建议,考虑不同地理区域的轴辐式模型。该提案基于最新文献和意大利医学肿瘤学协会(AIOM)的文件,欧洲皮肤肿瘤协会(EADO)基于欧洲共识的跨学科指南,国家综合癌症网络(NCCN)。我们最初讨论NMSC门诊,多学科工作组的作用,以及关于这个主题的轴辐式模型。然后,我们定义了特定于BCC和SCC的ICP过程。NMSC的ICP是一项创新战略,可确保尽可能高质量的医疗保健,而中枢和辐条模式对于组织不同的医疗保健结构至关重要。考虑到这一主题的重要性,必须在不同地理区域内建立有效的国际比较方案以及有效的组织。