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Renal Cancer Pathway Network Meeting

Monday 17rd June 2013

17.30 – 18.30pm

Hubworking, 5 Wormwood Street, London, EC2M 1RQ

| | |Action |

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

| |Several apologies received from members attending the BAUS conference | |

|2 |Introduction and Agenda (Tom Powles, Chair) | |

| |Update: this was held over for the next meeting | |

| |Draft Pathway for surgery and metastases presented for discussion | |

|3 |GS outlined the draft pathway that had been developed by herself and TP. | |

| |The surgical pathway proposes that following the success of the renal cancer pathway in North Central London sector,| |

| |all patients with an identified solid renal mass be referred to one of 2 or 3 renal SMDTs across the network. The | |

| |SMDT clinics would require additional same day CT imaging and reporting. It was felt key to improving outcomes. | |

| |It was noted that a review of patients currently referred to the RFH SMDT would be undertaken to estimate the future| |

| |workload for each of these centres. | |

| |FM agreed only cysts characterised as Bosniak T2F and above should be referred. TP and GS felt that it was important| |

| |that in the short term all suspected renal cancer should be assessed in the centres to ensure that the SMDT reviewed| |

| |cases. Assessment of the number of earlier abnormalities were required. | |

| |Discussion followed over the number of possible referrals and the willingness of radiologists to take on the role of| |

| |referring patients to the SMDT. The group agreed with the ideal of seeing all possible cancers but were unsure of | |

| |the scale of what was proposed. NR also stated that the degree to which 2F cysts could now be characterised had been| |

| |greatly improved by new technology. | |

| |FM proposed that there should be named radiologists from SMDTs that would support renal MDTs going forward. It was | |

| |agreed that help was required for all hospitals. | |

| |GS commented that in order to improve on current outcomes there needed to be a balance between the number of | |

| |patients that only required re-assurance and gate keeping by local centres vs those with serious tumours that spend | |

| |too long waiting to be referred to the SMDT. | |

| |BF asked the group what resources were going to be required to support a clinic and SMDT seeing all the proposed | |

| |referrals. TP felt that up to 90% of referrals could be protocolised and not seen at the clinic. | |

| |Further discussion took place on the possible number of cysts below 2F. It was agreed that NR would carry out a | |

| |review of the number of renal cysts that were occurred on each day at UCLH. This would give the group some idea of | |

| |the current standing of early renal abnomalities. |NR |

| |NR commented that a study of Bosniak T2Fs was needed to understand which ones would require follow up. RI and NR | |

| |also agreed to draft some radiological guidelines on navigating the pathway for renal masses of 2F and above for the| |

| |Pathway Network to consider at the meeting on 15th July. | |

| |It was agreed to close the meeting at this point and to discuss the Oncological Pathway at the next meeting on |NR/RI |

| |Thursday 4th July. | |

|4 |AOB – IR presented copies of the UCLH Renal Ablation Pathway – this will be circulated with the minutes. |GA/RI |

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

| |Thursday 4th July 2013 17.30 – 18.30pm | |

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

Future meetings are as follows:

|Monday 15th July |5.30 – 6.30pm |

|Thursday 1st August |5.30 – 6.30pm |

|Monday 12th August |5.30 – 6.30pm |

|Thursday 29th August |5.30 – 6.30pm |

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

Appendix 1 Attendees 17/06/13

|Name |Initials |Role |Base |

|Gillian Smith | |Consultant Surgeon & Clinical Lead |RFH |

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

|Beth Foley |BF | |RFH |

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

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

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

| | |Interim Clinical Lead Renal Cancer | |

| | |Consultant Oncologist | |

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

|Robin Woolfson |RW |Divisional Director, Transplant & Immunology Services |RFL |

| | |Consultant Nephrologist | |

Apologies received

|Name |Initials |Role |Base |

|Sudhansu Chitale | |Consultant |Whittington |

|John Peters | |Consultant Surgeon / Interim Surgical Lead NE London |Barts & WX |

|Nicola Rode | |CNS |BCF |

|Jane Coe | |CNS |UCLH |

|Frank Chinegwundu | |Consultant |Barts |

|Sandeep Gujral | |Clinical director |BHR |

|Ruth Evans | |Manager |NMH |

|Rateb Samman | |Consultant surgeon |PAH |

|Ekaterini Boletti | |Consultant Medical Oncologist |RFH |

|Chinma Obihara | |SMDT Co-ordinator (RCC) |RF |

|Rebecca Longmate |RL |Divisional Nurse Director |RFH |

|John Connolly |JC |Clinical Director, Renal / Urology |RFH |

|Angela Lee |AL |CNS |BHR |

|Lesley Emmett |LE |Service Manager |PAH |

|Cliodhna O'Sullivan |COS |CNS |RFH |

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

| | |Transplant & Immunology services | |

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