Table 1Migration of cancer stage 30 days after emergency evaluation.

n ¼ 150 Cancer stage 30 days after emergency evaluation

Total Curative NED Palliative Deceased

Cancer stage before emergency evaluation Total 150 50 30 52 18

No cancer before evaluation 16 11 e 4 1

Diagnostic 27 10 e 15 2

Curative 29 22 3 2 2

NED 44 7 27 6 4

Palliative 34 e e 25 9

S152 ABSTRACTS

Of the 70 patients with incurable disease or who died within 30 days,

32.9% had presented with intestinal obstruction and 15.7% with biliary

obstruction. Within 30 days after emergency evaluation, 47.1% had under-

gone surgery. The majority underwent intestinal bypass or ileo-/colostomy

for malignant intestinal obstruction (54.6%). Nevertheless, 48.5% of all

procedures started with non-palliative intent. During the last 30 days of

life, 88.8% of patients were hospitalized (median duration 9 e range

0e37 e days), and 52.9% of the deceased patients died during the hospital

stay.

Conclusions: Cancer stage and intention of treatment often migrate af-

ter emergency evaluation. In this study, the number of patients with incur-

able malignant disease and palliative stage had doubled after emergency

evaluation. Almost half of the patients who appeared to have poor prog-

nosis underwent surgery. When there is an indication for surgery, one

should consider the patient’s preferences and in what manner a surgical

procedure may influence the final outcome and the quality of a patient’s

life.

No conflict of interest.

http://dx.doi.org/10.1016/j.ejso.2014.08.384

395. Multidisciplinary Team (MDT) in cancer services: A model for

effective care?

M. Rees1, D. Winson1, Z. Kaposztas1, N. Kumar1

1 University Hospital of Wales, Cardiff Liver Unit, Cardiff Wales, United

Kingdom

Introduction: The concept of the MDT within cancer services has

gained much momentum since its initial inception, and is believed to

have contributed significantly to improving patient care over the last 20

years. As a result there is an increasing desire to monitor its effectiveness

in attempt to improve and standardize the care of cancer patients.

Method: We analyzed the outcome of all new patients discussed at a

single cancer MDT, discussing tertiary referrals for primary and secondary

liver malignancies, over a 6-month period (01/07/13e31/12/13). Each pa-

tient pathway through cancer services was mapped, including time lapses

between each clinical contact, in an attempt to characterize MDTworkload

and effectiveness.

Results: There were 302 patients discussed over a 6-month period

through 25 sessions, of which 132 were new referrals. Median patient

age was 70 (range ¼ 20e94) and median wait from referral to discussion

was 18 days (range ¼ 11e61). Referrals were received from all 5 South

Wales LHB’s and over half of patients (56%) were discussed in relation

to colorectal liver metastases. 30% (n ¼ 36) of patients were deemed palli-

ative at initial MDT discussion while 27% (n ¼ 32) were referred for liver

surgery. A quarter of patients (n ¼ 32) required further investigation prior

to definitive treatment and 10 patients (8%) of those discussed were found

to have benign disease. Median time from first MDT to definitive treatment

was 77 days (range ¼ 3e406) and median time from to surgery was 66

days (range ¼ 3e160). Twenty-three patients (17%) required more than

one discussion at MDT prior to definitive treatment. Patient management

changed from initial MDT outcome in 14% of cases following clinical re-

view, specialist opinion or in light of additional information.

Conclusion: MDT remains an effective and efficient way of discussing

patient management on a case-by-case basis in the setting of cancer. Effi-

ciency improvements could be made by prompter access to radiology, bet-

ter provision of clinical information by the referrer and mandatory

attendance/representation by all clinicians involved in patient care.

No conflict of interest.

http://dx.doi.org/10.1016/j.ejso.2014.08.385

396. Photodynamic diagnostics of tissue fluids caused by oncological

pathology

L. Bloznelyte-Plesniene1

1 Vilnius University Institute of Oncology, Laboratory of Laser and

Photodynamic Therapy, Vilnius, Lithuania

Background: Tumor pathology accounts for 7e10% of all ascites and

16.5e30% of all pleurisy cases. Cytological tests of pleural punctuate

reveal malignant pathology only in 60% of all subjects suffering from ma-

lignant pleurisies. Providing cytological tests of ascites, cancer cells are

found only in 40e60% of all cases of ascites, caused by malignant pathol-

ogies. The aim of this work e to deal with our experience concerning the

photodynamic diagnostics (PDD) of tissue fluids caused by oncological

pathology.

Material and methods: PDD of the malignant tissue liquids is a fairly

simple non-invasive method. It comprises a systematic injection of a

photosensitizer into a patient having an accumulation of tissue liquids. A

liquid is punctured after a time interval which is required for the photosen-

sitizer to accumulate selectively in the tumor tissue. The tissue liquid is

illuminated with a non-intensive 400e405 nm violet light. If an accumu-

lation of tissue liquid was caused by an oncological pathology, then the

liquid will contain floating individual tumor molecules. There were 32

oncological patients who underwent photodynamic therapy and were sub-

jected to puncturing of tissue liquids from various cavities, whereby ex-

tracted puncture liquid was subjected to the PDD. 12 patients received

pleural puncturing, 12 e puncturing of ascites, 1 e puncturing of peri-

cardia, 2 e puncturing of the non-malignant neck cysts, 5 e puncturing

of tissue liquids of metastases of the collapsing tumors in a neck zone. 1

patient was punctured in the knee joint for liquids, which had accumulated

because of sarcoma, 7 patients were punctured in the stasis tissue liquid

caused by postoperative stasis phenomenon.

Results: From the 32 patients who were subjected to puncture of tissue

liquids and its analyses in 7 subjects cause of said tissue liquids was a non-

malignant pathology, in 23 subjects tissue liquids were caused by an onco-

logical pathology, and for 2 subjects tissue liquids were caused by both a

non-malignant and oncopathology. In 24 patients the tissue liquid caused

by an oncopathology had the characteristic glow when subjected to the

PDD. In one patient the ascites caused by a melanoma did not have the

characteristic glow when subjected to the PDD. According to our data

this test has sensitivity of 96% and specificity of 100%. The test is sensitive