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Discrepancy between second and first opinion in surgical oncological patients
W A M Mellink1, S C Henzen-Logmans, A H H Bongaerts
1Department of Surgical Oncology, Erasmus Medical Center Rotterdam/Daniel den Hoed, Rotterdam, The Netherlands.
Summary
A third of cancer patients seeking a second opinion experienced a discrepancy with their initial diagnosis. Half of these oncology second opinions led to significant changes in treatment or prognosis.
Area of Science:
- Oncology
- Medical Diagnostics
- Patient Care
Background:
- Second opinions are crucial for validating cancer diagnoses and treatment plans.
- Understanding discrepancies in oncological second opinions is vital for improving patient outcomes.
Purpose of the Study:
- To prospectively analyze oncological second opinion outcomes.
- To determine the frequency and extent of discrepancies between initial and second opinions.
- To identify the patterns of further treatment and follow-up post-second opinion.
Main Methods:
- Prospective study of 466 patients seeking a second opinion at a Surgical Oncology Outpatient Clinic.
- Registration of patient characteristics, histopathological and radiological material revisions.
- Development of a classification system for opinion discrepancies.
Main Results:
- Of 403 eligible patients (mean age 52, 87% female, 83% breast cancer), revisions impacted treatment/prognosis in 3-2% of cases.
- A discrepancy between first and second opinions occurred in 32% of cases (16% major, 16% minor).
- 78% of patients were referred back to their original specialist for further treatment.
Conclusions:
- One-third of patient-initiated second opinions reveal discrepancies with the initial assessment.
- Approximately half of these discrepancies necessitate major alterations in patient therapy or prognosis.