Multidisciplinary teams in cancer care: are they effective in the UK?

Fleissig, Anne; Jenkins, Valerie; Catt, Susan; Fallowfield, Lesley

doi:10.1016/s1470-2045(06)70940-8

Cited by 532 publications

(441 citation statements)

References 51 publications

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“…Certainly, the teamwork between the different consultants (gastro-enterology, surgery, radiology, radiotherapy, pathology) plays an important role. The existence of a good multidisciplinary infrastructure in which every patient is discussed in multidisciplinary meetings for an individual treatment regimen, seems an important factor for good outcomes 28 . Quality of surgical wards and intensive care units are likely to be an important factor influencing outcome.…”

Section: Discussionmentioning

confidence: 99%

Volume and outcome in colorectal cancer surgery

Gijn

Gooiker

Wouters

et al. 2010

European Journal of Surgical Oncology (EJSO)

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AimsThere is a growing consensus to concentrate high-risk surgical procedures to highvolume surgeons in high-volume hospitals. However, there is fierce debate about centralizing more common malignancies such as colorectal cancer. The objective of this review is to conduct a meta-analysis using the best evidence available on the volume-outcome relationship for colorectal cancer treatment. MethodsA systematic search was performed to identify all relevant articles studying the relation between hospital and/or surgeon volume and clinical outcomes for colorectal cancer. Using strict inclusion criteria, 23 articles were selected concerning colon cancer, rectal cancer or both diseases together as 'colorectal cancer'. Pooled estimated effect sizes were calculated using the casemix adjusted outcomes of the highest volume group opposed to the lowest volume group. Results High ConclusionsThe results show a clear and consistent relation between high volume providers and improved long term survival. This applies to both high volume hospitals and high volume surgeons. Most results show a relation between high volume providers and a reduced postoperative mortality, but evidence is less convincing.In the ideal world, extensive population based audit registrations with casemix adjusted feedback should make rigid minimal volume standards obsolete. Until then, using volume criteria for hospitals and surgeons treating colorectal cancer can improve mortality and especially long term survival.

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Section: Discussionmentioning

confidence: 99%

Volume and outcome in colorectal cancer surgery

Gijn

Gooiker

Wouters

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…Research on the effectiveness of MDMs and MDTs in cancer management is lacking, [5][6][7][8] and, although suggestions have been made regarding the advantages and disadvantages of an MDT approach to cancer care (see Table 1), no systematic reviews have yet been performed. 9 Information regarding the function and benefits of the colposcopy MDT is even rarer, with, to date, only one publication reporting an activity review.…”

Section: Introductionmentioning

confidence: 99%

The multidisciplinary colposcopy meeting: recommendations for future service provision and an analysis of clinical decision making

Palmer

Wales

Ellis

et al. 2010

BJOG

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Methods Retrospective review of the colposcopy database (Sept 2003-Sept 2009, cross-referenced with multidisciplinary team (MDT) letters, patient notes and the hospital results reporting system. Baseline statistics were used for data analysis.Main outcome measures Indications for MDT referral; concordance rates from cytopathology and histopathology review; concordance rates between MDT treatment decisions and final patient management.Results A total of 535 cases were discussed at 62 MDT meetings during the allocated study period. Discrepancy between referral cytology and cervix punch biopsy was the most common referral (49%). Cytology and histology review concurred with the initial reports in 75.8 and 97.8% of cases, respectively; the MDT decision was concordant with the final patient management in 97% of cases. The main reason for discordance (67%) resulted from patient factors.Conclusions When significant discrepancies exist between colposcopy, cytology and histopathology, then MDT discussion seems pertinent as MDT discussion can lead to the avoidance of over-treatment. To improve timeliness of treatment, MDT meetings should occur at least monthly. The results of each case discussion should be recorded in the patient case notes, the minutes of each meeting should be circulated to all MDT members and a letter describing MDT recommendations must be sent to the colposcopist responsible for patient care.Keywords Colposcopy, cytology, gynaecology, multidisciplinary team, multiprofessional.Please cite this paper as: Palmer J, Wales K, Ellis K, Dudding N, Smith J, Tidy J. The multidisciplinary colposcopy meeting: recommendations for future service provision and an analysis of clinical decision making.

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“…A multidisciplinary cancer team has been defined as professionals of different health care disciplines who meet as a group at a given time (whether physically in one place or by video-or teleconferencing) to discuss a given patient and who are able of contributing independently to the diagnostic and treatment decisions about the patient [3]. The team composition is dependent on the tumour site, which should include specialists in the diagnostic area (pathology, nuclear medicine, radiology) in the therapeutic area (surgeons, medical oncologists, radiation oncologists, other specialties) nurses, psychooncologists, palliative care physicians, and others, according to each hospital and locally available resources.…”

Section: O Ne Of the Key Recommendations Of The Spanish Cancermentioning

confidence: 99%