Intercontinental Multidisciplinary Oncology Videoconferencing between the South Pacific and the French mainland: Reasons for medical evacuation after more than 2000 cases of cancers discussed

Introduction: Disparities in care between the French mainland and overseas territories are responsible for unequal access to innovative and specialized care, leading to an increased death risk for cancer patients. Since 2019, a multidisciplinary consultation meeting (RCP Pacifique) by videoconference between French Polynesia (Pf), New Caledonia (NC) and mainland France, facilitates access to medical expertise and limits the use of medical evacuations (EVASAN). Methods: We retrospectively analyzed all files discussed in the RCP Pacifique between 2019 and 2024 to report demographic data, reasons for EVASAN and post-EVASAN developments. Results: Of the 2010 discussions concerning 1159 patients, 242 EVASAN decisions were made (12% of discussions; 20.9% of patients) for 119 Pf patients (49.2%) and 123 NC patients (50.8%). The main reasons for EVASAN decided were: surgery (48.3%), interventional radiology procedure (14.0%), complex radiotherapy (14.0%) and PET-scan (12.4%). Despite a recommended EVASAN, 30 patients were not evacuated for the following reasons: treatment in an Australian center, emergency requiring treatment at home, resolution of the problem via teleconsultation, COVID confinement, and patient refusal. After EVASAN, 82.6% of patients returned home after treatment. Conclusions: The RCP Pacifique offers a solution to limit the use of EVASAN in overseas territories, while guaranteeing fair access to care. Strengthening local infrastructure and increased transfer of technical skills are the keys to developing this goal.