Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer?

Bergamini, Cristiana; Locati, Laura D.; Bossi, Paolo; Granata, Roberta; Alfieri, Salvatore; Resteghini, Carlo; Imbimbo, Martina; Fallai, C.; Orlandi, Ester; Tana, S.; Iacovelli, Nicola Alessandro; Guzzo, Marco; Ibba, Tullio; Colombo, Sarah; Bianchi, Roberto; Pizzi, Natalia; Fontanella, Walter; Licitra, Lisa

doi:10.1016/j.oraloncology.2016.01.001

Cited by 56 publications

(53 citation statements)

References 27 publications

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“…A study performed in the Netherlands found that MDTs corrected 20% of referral diagnoses in patients with gastrointestinal malignancies . This is supported by multiple studies covering various tumour streams that show MDTs impact the management of patients, including diagnosis and treatment plans . One such study of patients with prostate cancer who participated in a multidisciplinary clinic approach were found to have improved survival rates when compared with national data.…”

Section: Introductionmentioning

confidence: 91%

“…Given the increasing complexity of cancer treatment, it is essential that health professionals work as a multidisciplinary team to ensure the best outcomes for patients. There are several studies that show MDTs improve cancer outcomes, reduce time from diagnosis to treatment, improve patient satisfaction and recruitment to trials and provide ongoing education for clinicians . A study performed in the Netherlands found that MDTs corrected 20% of referral diagnoses in patients with gastrointestinal malignancies .…”

Section: Introductionmentioning

confidence: 99%

“…There are several studies that show MDTs improve cancer outcomes, reduce time from diagnosis to treatment, improve patient satisfaction and recruitment to trials and provide ongoing education for clinicians. [1][2][3][4] A study performed in the Netherlands found that MDTs corrected 20% of referral diagnoses in patients with gastrointestinal malignancies. 1 This is supported by multiple studies covering various tumour streams that show MDTs impact the management of patients, including diagnosis and treatment plans.…”

Section: Introductionmentioning

confidence: 99%

“…1 This is supported by multiple studies covering various tumour streams that show MDTs impact the management of patients, including diagnosis and treatment plans. 2 One such study of patients with prostate cancer who participated in a multidisciplinary clinic approach were found to have improved survival rates when compared with national data. They also noted high patient satisfaction that may also be linked with reduced treatment regret.…”

Section: Introductionmentioning

confidence: 99%

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Referral rates to multidisciplinary team meetings: Is there disparity between tumour streams?

et al. 2019

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Introduction The multidisciplinary team meeting (MDTM) approach is accepted as standard of care to optimise treatment for patients diagnosed with cancer. This retrospective audit reviews the proportion of patients whose care is being discussed at cancer MDTMs within the Sunshine Coast Hospital and Health Service (SCHHS). Methods Patients included were those diagnosed with cancer within the SCHHS between 2010 and 2015, and subsequently referred to a public MDTM for discussion. Data were extracted from the Queensland Cancer Control Analysis Team (QCCAT) database regarding the incidence of breast, lung, upper gastrointestinal (GI), colorectal, genitourinary and malignant haematological cancers and the number of patients referred to the corresponding MDTM. Results Data from 2015 show referral rates to MDTMs as follows: lung 100%, upper gastrointestinal 100%, colorectal 64%, breast 60%, malignant haematology 40% and genitourinary 28%. Of the genitourinary presentations, 70% were prostate cases and 14% bladder cases. Review of genitourinary MDTM outcomes found that, of the patients with prostate cancer discussed, 30% were metastatic, 19% were poor surgical candidates and 15% had biochemical recurrence. Conclusion This audit demonstrates variable utilisation of MDTMs between tumour streams. Our study shows a high and increasing referral rate to all tumour stream MDTMs except for genitourinary. This suggests a possible underutilisation of genitourinary MDTMs to discuss treatment options for patients with genitourinary cancer. Collaborative research is warranted to further investigate whether this is a local or widespread issue.

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Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Referral rates to multidisciplinary team meetings: Is there disparity between tumour streams?

et al. 2019

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“…Multiple publications support the value the MDT and its cost‐effectiveness in the cancer treatment process . In head and neck cancer, review in an MTB affects and refines treatment plans in up to 30% to 60% of cases . Despite data showing the effects of MTB, there is a paucity of data showing survival benefit of MTB, with limited studies showing a survival impact in head and neck cancer …”

Section: Introductionmentioning

confidence: 99%

The impact of the multidisciplinary tumor board on head and neck cancer outcomes

et al. 2019

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Objectives/Hypothesis Although the multidisciplinary tumor board (MTB) is accepted as best practice for the management of head and neck squamous cell carcinoma (HNSCC), there is limited evidence showing its impact on survival. Our goal was to investigate the impact of an MTB following the hiring of a fellowship‐trained head and neck surgeon and implementation of an MTB at our institution. We hypothesized that these changes would demonstrate an improvement in survival. Study Design Retrospective chart review. Methods A review of HNSCC treated at our institution between October 2006 and May 2015 was performed. The cohort was divided into pre‐MTB (October 2006–February 2011) and post‐MTB (February 2011–May 2015) cohorts. Patient demographics, cancer stage, and treatment outcomes were reviewed. Univariate, multivariate, and survival analysis were performed. Results The study included 224 patients, 98 in the pre‐MTB cohort and 126 in the post‐MTB cohort. Of total patients, 139 (62%) were black and 91 (40%) were on Medicaid or uninsured. Average follow‐up time was 2.8 years, and most cases were advanced stage (68%). On Kaplan‐Meier evaluation, overall survival and disease‐specific survival were significantly improved in the post‐MTB cohort compared with the pre‐MTB cohort, with a 5‐year disease‐specific survival of 52% vs. 75% (P = .003). A matched cohort analysis showed that the post‐MTB cohort had significantly lower risk of death (hazard ratio: 0.48). Conclusions Our study demonstrates that treatment of HNSCC by a dedicated multidisciplinary team results in improved survival. Multidisciplinary care should be considered best practice in the care of HNSCC. Level of Evidence 3b Laryngoscope, 130:946–950, 2020

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Overcoming sociodemographic factors in the care of patients with testicular cancer at a safety net hospital

Chertack

Ghandour

Singla

et al. 2020

Cancer

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Background The objective of this study was to determine whether standardized treatment of germ cell tumors (GCTs) could overcome sociodemographic factors limiting patient care. Methods The records of all patients undergoing primary treatment for GCTs at both a public safety net hospital and an academic tertiary care center in the same metropolitan area were analyzed. Both institutions were managed by the same group of physicians in the context of multidisciplinary cancer care. Patients were grouped by care center; clinicopathologic features and outcomes were analyzed. Results Between 2006 and 2018, 106 and 95 patients underwent initial treatment for GCTs at the safety net hospital and the tertiary care center, respectively. Safety net patients were younger (29 vs 33 years; P = .005) and were more likely to be Hispanic (79% vs 11%), to be uninsured (80% vs 12%; P < .001), to present via the emergency department (76% vs 8%; P < .001), and to have metastatic (stage II/III) disease (42% vs 26%; P = .025). In a multivariable analysis, an absence of lymphovascular invasion (odds ratio [OR], 0.30; P = .008) and an embryonal carcinoma component (OR, 0.36; P = .02) were associated with decreased use of adjuvant treatment for stage I patients; hospital setting was not (OR, 0.67; P = .55). For patients with stage II/III nonseminomatous GCTs, there was no difference in the performance of postchemotherapy retroperitoneal lymph node dissection between the safety net hospital and the tertiary care center (52% vs 64%; P = .53). No difference in recurrence rates was observed between the cohorts (5% vs 6%; P = .76). CONCLUSIONS Sociodemographic factors are often associated with adverse clinical outcomes in the treatment of GCTs; they may be overcome with integrated, standardized management of testicular cancer.

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Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer?

Cited by 56 publications

References 27 publications

Referral rates to multidisciplinary team meetings: Is there disparity between tumour streams?

Referral rates to multidisciplinary team meetings: Is there disparity between tumour streams?

The impact of the multidisciplinary tumor board on head and neck cancer outcomes

Overcoming sociodemographic factors in the care of patients with testicular cancer at a safety net hospital

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