A MULTIDISCIPLINARY TEAM - CENTRED ONE-STOP THYROID NODULE CLINIC REDUCES DELAY IN THYROID CANCER DIAGNOSIS AND MANAGEMENT - A SINGLE INSTITUTIONAL EXPERIENCE

AUTHORS:
A. Al Omar (London, United Kingdom) , H.B. Oh (London, United Kingdom) , A. Ahmed (London, United Kingdom) , A. Abdelsalam (London, United Kingdom) , V. Garcia (London, United Kingdom) , T. Kurzawinski (London, United Kingdom) , A. Al Lawati (London, United Kingdom) , S. Pomplun (London, United Kingdom) , S. Amin (London, United Kingdom) , M. Gutierrez-Arniaz (London, United Kingdom) , F. Monne (London, United Kingdom) , D. Flynn (London, United Kingdom) , T. Abdel-Aziz (London, United Kingdom)
Background:
Thyroid nodules are a common presentation in the surgical clinic. Patients are often referred by the GP under the 2-week wait rule in the UK. Majority of these nodules are benign but require an US scan and in many cases an US-FNAC. We launched the Multidisciplinary Team (MDT) one-stop clinic (OSC) in January 2022 to streamline services and improve patients' experience.
Methods:
Demographics, cytology reports and management plans of all patients who attended the OSC from January 2022-March 2023 were reviewed from the electronic medical records. Time to definitive surgery was also reviewed and patients were followed up for a minimum of 6 months.
Results:
308 patients attended OSC (Females:251(81%),Males:57(19%)). 144(47%) were symptomatic while 164(53%) were incidental. 113(37%) had palpable thyroid nodules with only 7% having a Family History of Thyroid Cancer. 144(47%) patients had thyroid nodules targeted for FNAC and 72(50%) patients were diagnosed with definite/suspected malignancy. 65(45%) patients with benign cytology had their results explained to them via telemedicine. All patients with malignant/indeterminate results were discussed in the same-day MDT with a median time to definitive/diagnostic surgery of 27 days. Of note, only 5% had a non-diagnostic (Thy1) result.
Conclusions:
A comprehensive one-stop clinic reduces patient visits and delays in thyroid cancer diagnosis and management. In addition, 75% of patents were reassured that they do not have Thyroid cancer with results discussed on the same day. To our knowledge, this is the first novel one-stop thyroid clinic with same-day cytology results, MDT review and counselling for management.