Patterns of unscheduled oncologic consultations at a tertiary center in North Africa: Are we treating emergencies or filling gaps?

Abstract

e13622 Background: Improvements in cancer treatment have improved survival, transforming many malignancies into chronic diseases. This evolution has led to an increasing number of acute situations requiring rapid and specialized oncological management owing to the complexity of the disease. Understanding the context of unscheduled oncology consultations is essential to ensure effective patient management and optimizing patient flow within oncology services, particularly in low- and middle-income settings. ObjectivesThis study aimed to identify the reasons why patients seek unscheduled medical oncology consultations and to evaluate the clinical appropriateness of these visits. Methods: This descriptive prospective study was about 202 patients who attended unplanned consultations at the Department of Medical Oncology with an analysis of demographic, clinical characteristics, referral mode, consultation reason, deployed resources and outcomes. Results: Breast (55%) and digestive (15%) cancers are the most common. 87% patients were receiving active anticancer therapy at the time of consultation and 54% had metastatic disease. 91% patients were self-referred. Consultations were primarily for administrative issues (38%), only 18% patients presented for true emergencies, mainly due to pain (8%). 14% of patients benefit from diagnostic and therapeutic procedures. 14% had attended similar consultations within the previous three months. Disease progression was confirmed in 14% of cases, and mortality rate is 2% in the overall cohort, rising to 8% among patients presenting with true oncological emergencies. Conclusions: Most unscheduled oncological consultations were non-urgent, illustrating the need for patient education and structured care pathways, while true oncological emergencies constituted only a small proportion, indicating where clinical attention and resources should be prioritized.