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Renal Cancer Pathway Network Meeting

Monday 9th September 2013

17.30pm – 18.30pm

Hubworking, 5 Wormwood Street, London, EC2M 1RQ

| | |Action |

|1. |Apologies ( see Appendix 1) | |

|2 |Introduction and Agenda (Gillian Smith, Chair) | |

| |A paper was presented by NR on the Diagnostic Pathway for Renal Cancer. This included : | |

| |Initial Pathway for Suspected Renal Cancers | |

| |Renal Cancer MDT review | |

| |Pathway notes and CT/MRI protocols | |

|3 |Initial Pathway for Suspected Renal Cancers | |

| |NR updated the group on the background to the group and the reasoning behind the draft pathway. He informed the group | |

| |that the paper was the basis for a discussion to lead to an agreed approach by the Renal Cancer Pathway group. | |

| |A discussion was held around the Bosniak grade for a suspicious lesion to be reviewed on the pathway. NR felt that 2F | |

| |should be included and information entered into a database so the patient is tracked and checked for 5 years. | |

| |Contrast Renal MRI & CT: Although some local centres do use contrast MRI and CT for renal patients this was not agreed | |

| |across the sector and the group was informed that NICE were about to publish guidelines. It was agreed that nephrologists| |

| |(Robin Woolfson and Mark Harber) to be asked for advice on use of MRI contrast in low GFR and GFR guidelines for renal | |

| |failure. | |

| |Renal radiology reporting – it was decided that reporting at local renal centres should be done by a Consultant | |

| |Radiologist (with experience in Renal CT), it was agreed that if this person agrees it is suspicious it should then be | |

| |fast tracked to the SMDT. | |

| |The role of the Specialist MDT was discussed – TP commented that the North Central sector is a long way ahead of the North|Mark Harber / GS/ Robin |

| |East sector as they have a dedicated renal MDT. The North East sector still have non-specific urology MDT’s at Queen’s |Woolfson |

| |(BHRUT) and Barts Health so around 6 months behind in development of this concept. It is not clear how the move will be | |

| |made from the local MDT into the specialised MDT and ensure that the procedure is carried out in a short period of time. | |

| |It was suggested that obvious renal abnormalities that need to be addressed are fast tracked to the specialist MDT and the| |

| |other lesions may still go through a local system for the time being to ensure the specialist MDT is not swamped with | |

| |non-cancer renal lesions. | |

| |It was agreed that the fast track system will be piloted in the North Central sector. Consultant radiologists who have a |TP/AG |

| |clearly suspicious mass which is above a 2F can be referred straight into the SMDT clinic. If it is successful it will be | |

| |extended out throughout the sector. | |

| |It was suggested to have 2 Consultant radiologists from each site should be available to call into the SMDT meeting so the| |

| |load is shared. | |

| |There was a discussion regarding including 2F in the pilot as it was felt by some members that this would provide an | |

| |unsustainable increase in workload for the SMDT. It was however agreed that their inclusion would be to establish the | |

| |number of them that are actual 3’s and 2’s be reviewed regularly and results reported back to the meeting.. | |

|6 |AOB None | |

|7. |Date/Time and Venue of Next Meeting: | |

| |Monday 7th October 2013 17.30 – 18.30pm | |

| |Hubworking, 5 Wormwood Street, London, EC2M 1RQ | |

Future meetings are as follows:

|Thursday 7th November |5.30 – 6.30pm |

|Monday 9th December |5.30 – 6.30pm |

All at Hubworking, 5 Wormwood Street, London, EC2M 1RQ

Appendix 1 Attendees 04/07/13

|Name |Initials |Role |Base |

|Gillian Smith |GS |Consultant Surgeon & Service Line Lead |RFL |

|Tom Powles |TP |Chair Network Pathway group, |Barts Health |

| | |Interim Clinical Lead Renal Cancer | |

| | |Consultant Oncologist | |

|Geraldine Alder |GA |Project Manager RCC |RFL |

|Angela Lee |AL |CNS |BHR |

|Navin Ramachandran |NR |Interventional Oncology / Ablation |UCLH |

|Antony Goode |AG |Consultant radiologist |RFL |

|Natalie Butt |NB |General Manager |PAH |

|Jeevan Kumaradeevan |JK |Consultant radiologist |WH |

|Robert Katz |RK |Consultant radiologist |WH |

|Anju Sahdev |AS |Consultant radiologist |Barts |

Apologies received

|Name |Initials |Role |Base |

|Faiz Mumtaz |FM |Consultant Surgeon / Interim Surgical Lead, NC London |BCF / RFL |

|Sue Lyons |SL |Divisional Operations Director,, |RFL |

| | |Transplant & Immunology services | |

|Beth Foley |BF |Operations Manager |RFL |

|Rowland Illing |RI |Interventional Oncology / Ablation |UCLH |

|Shelley Coombs |SC |CNS |RFL |

|Frank Chinegwundoh |FC |Consultant Urologist |Barts / Newham |

|John Connollys |JC |Clinical Lead, Urology | |

|Guy Webster |GW |Consultant surgeon |BCF / RFL |

|Miles Walkden |MW |Interventional Oncology / Ablation |UCLH |

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