Is it worth reorganising cancer services on the basis of multidisciplinary teams (MDTs)? A systematic review of the objectives and organisation of MDTs and their impact on patient outcomes

Abstract

a b s t r a c tMultidisciplinary teams (MDTs) are considered the gold standard of cancer care in many healthcare systems, but a clear definition of their format, scope of practice and operational criteria is still lacking. The aims of this review were to assess the impact of MDTs on patient outcomes in cancer care and identify their objectives, organisation and ability to engage patients in their care. We conducted a systematic review of the literature in the Medline database. Fifty-one peer-reviewed papers were selected from November 2005 to June 2012. MDTs resulted in better clinical and process outcomes for cancer patients, with evidence of improved survival among colorectal, head and neck, breast, oesophageal and lung cancer patients in the study period. Also, it was observed that MDTs have been associated with changes in clinical diagnostic and treatment decision-making with respect to urological, pancreatic, gastro-oesophageal, breast, melanoma, bladder, colorectal, prostate, head and neck and gynaecological cancer. Evidence is consistent in showing positive consequences for patients' management in multiple dimensions, which should encourage the development of structured multidisciplinary care, minimum standards and exchange of best practices.

A multidisciplinary group for prostate cancer management: A single institution experience

“…Other clinical-based goals included improving patients' quality of life and setting up a structured follow-up care plan. As it happens in our Hospital, there is a weekly scheduled day in which the MDT meet, with simultaneous data evaluation, management discussion, and patient consultations from a multidisciplinary team of PC specialists, and this is feasible (8,9).…”

Sigmoido-Uterine Fistula Caused by Ovarian Cancer

“…So we organized a discussion with the multidisciplinary team. We considered the discussion with the multidisciplinary teams was important to diagnose and treat complex neoplasms according to our some cases and some references [13] [14]. After the discussion with the multidisciplinary teams, the possibility of origins from uterus or urinary bladder was excluded, but the possibility of origin from sigmoid or ovary or retroperitoneal tissue was still not certain.…”

Best supportive care for idiopathic pulmonary fibrosis: current gaps and future directions

“…It includes specialists with expertise in the care of ILDs, physiotherapists, occupational medicine professionals and professionals with expertise in the delivery of oxygen therapy, while psychologists, medical counsellors and professionals with expertise in providing palliative care are also very important for patients with progressive forms of ILDs. One of the main advantages of such organisation is the possibility to optimise the flow of patients, minimising delays in access to treatments and interventions, and at the same time giving a clear reference to patients, who often feel alone with their disease [13].…”

“…Most of the evidence about the efficacy of BSC in progressive diseases is derived from oncology, where it is recognised that BSC can influence survival [13]. Therefore, its role should be carefully considered when designing multicentre randomised trials [14,15].…”