The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer☆

Freeman, Richard K.; Woerkom, Jaclyn M. Van; Vyverberg, Amy; Ascioti, Anthony J.

doi:10.1016/j.ejcts.2010.01.051

Cited by 113 publications

(109 citation statements)

References 11 publications

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“…Lung cancer prognosis and outcomes depend not only on histological characteristics and staging of the cancer but also on the presence and proper management of comorbidities, local symptoms, treatment-related morbidity, and quality of life (32)(33)(34). Data show that high-volume centers and multidisciplinary teams are more efficient at managing patients with lung cancer than low-volume or nonmultidisciplinary centers by providing more complete staging, better adherence to guidelines, and increased survival (23,26,31). These data supporting multidisciplinary teams are included in national guidelines for lung cancer centers under the coordination of chest physicians (35).…”

Section: Importance Of High-volume Specialized Centers and Multidiscimentioning

confidence: 99%

“…They also perform the preoperative physiological evaluation, provide postresection surveillance, and treat the patients' most common comorbidities, such as COPD, pleural effusions, lung infections, and respiratory failure. These comorbidities also affect the performance status of patients and their ability to undergo surgery (22,23). Moreover, pulmonologists can provide treatment by local and endoscopic approaches, such as laser and cauterization, and they can treat early-stage central lung cancer by established endobronchial techniques such as photodynamic therapy.…”

Section: Evaluation Staging and Treatmentmentioning

confidence: 99%

“…Data show that multidisciplinary teams provide improved adherence to evidence-based guidelines, better treatment decisions, and better clinical outcomes with longer survival for oncologic patients (27,28), and specifically for patients with lung cancer (23,29). Pulmonologists participate in and often lead multidisciplinary efforts to provide prompt, state of the art, and costeffective care to patients with lung cancer.…”

Section: Evaluation Staging and Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

An Official American Thoracic Society/European Respiratory Society Statement: The Role of the Pulmonologist in the Diagnosis and Management of Lung Cancer

Gaga¹,

Powell²,

Schraufnagel³

et al. 2013

Am J Respir Crit Care Med

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Section: Importance Of High-volume Specialized Centers and Multidiscimentioning

confidence: 99%

Section: Evaluation Staging and Treatmentmentioning

confidence: 99%

Section: Evaluation Staging and Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

An Official American Thoracic Society/European Respiratory Society Statement: The Role of the Pulmonologist in the Diagnosis and Management of Lung Cancer

Gaga¹,

Powell²,

Schraufnagel³

et al. 2013

Am J Respir Crit Care Med

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“…Multimodality treatment can be simultaneous or consecutive, palliative or with curative intent, and can involve multiple physicians over the course of months or years. 10 As surgeons, medical and radiation oncologists, and other physicians and nonphysicians become involved in the care of patients receiving multimodality treatment, developing a treatment plan that encompasses the expertise of all these providers becomes complex. Among patients with colon or rectal cancer, a higher physician engagement MDC level was associated with a shorter time to treatment.…”

Section: Colon Cancermentioning

confidence: 99%

“…4,5 Studies have quantified the impact of MDC on processes of care as well as patient, provider, and system outcomes. 1,[5][6][7][8][9][10][11][12][13][14][15][16] Available evidence indicates that there are measurable advantages to coordinating care through multidisciplinary conferences. 1,7,11,[17][18][19] One study documented an increase in the percentage of patients receiving complete staging and increased likelihood of adherence to clinical care guidelines, concurrent with a smaller interval from diagnosis to treatment among patients with esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

ReCAP: Impact of Multidisciplinary Care on Processes of Cancer Care: A Multi-Institutional Study

Onukwugha

Petrelli

Castro

et al. 2016

JOP

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QUESTION ASKED: What is the relationship between the level of implementation of multidisciplinary care (MDC) and various processes of cancer care (eg, time to treatment receipt, evaluation for enrollment onto a clinical trial) among community cancer centers serving patients diagnosed with colon, rectal, or lung cancer? There is limited generalizable evidence on this topic. It is important to answer this question using data that can generalize across cancer patients, the majority of whom receive treatment in a community cancer center. SUMMARY ANSWER: Focusing on the time to receipt of cancer-directed treatment as one key process of cancer care in this patient population, we found that the answer to our question depended on the MDC assessment area and tumor site ( Table 1 ). Among patients with colon cancer, higher MDC levels of physician engagement (ie, a higher level of physician engagement at the institutional level) were associated with a shorter time to treatment receipt, whereas higher MDC levels of case planning were associated with a longer time to treatment receipt. Among patients with rectal cancer, higher MDC levels of physician engagement were associated with a shorter time to cancer-directed treatment receipt, whereas higher MDC levels of evaluation for enrollment onto clinical trials were associated with a longer time to treatment receipt. Among patients with lung cancer, there was no association between the MDC areas of assessment and the time to cancer-directed treatment receipt. [Table: see text] METHODS: We collected data for patients receiving care at 14 National Cancer Institute (NCI) community cancer centers. We characterized the NCI community cancer centers according to their level of MDC implementation across seven MDC assessment areas and over time. Using statistical regression models, we investigated the relationship between the level of MDC implementation and various process measures, including time to treatment receipt, clinical trial evaluation, receipt of multimodality treatment, and adherence to treatment guidelines published by the National Comprehensive Cancer Network. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: In the absence of a validated MDC assessment tool, the NCI community cancer centers used a nonvalidated tool. Additional institutional-level data would have been useful for characterizing norms and practices that may have differed across cancer centers and potentially explained variation in care processes. Although we controlled for patient demographic characteristics, baseline data were not available to document patient comorbidity or performance status level. To the extent that cancer centers at higher levels of MDC implementation may have been more likely to treat clinically complex patients, the inability to control for potential confounding bias caused by patient case mix may have influenced the study results. REAL-LIFE IMPLICATIONS: MDC models are important decision-making forums in current oncology practice. They involve oncologists in generating a comprehensive and coordinated plan of care for patients. Although MDC is purported to offer benefits to patients, there is limited generalizable evidence regarding the benefit to individuals receiving care at community cancer centers in the United States. Across various care processes that are important for characterizing cancer care, this study’s results indicate that changes in the level of MDC implementation could differentially affect the process of care, depending on the MDC area of assessment and the cancer site. In addition, the study results can be used to generate hypotheses for future studies among individuals diagnosed with colon, rectal, or lung cancer.

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Outcomes of multidisciplinary treatment planning in US cancer care settings

Das

Baker

Altice

et al. 2018

Cancer

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Multidisciplinary treatment planning (MTP) is a process of engaging multiple disciplines to develop or refine the disease management plan. It is widely implemented in US cancer treatment settings and is considered to have favorable effects on both care quality and other outcomes. However, evidence reviews to date regarding MTP effectiveness have based their conclusions on studies conducted predominantly outside the United States. The authors conducted a systematic review of US-based studies to synthesize and critically appraise evidence of the effects of MTP on cancer care quality, health services outcomes, and survival. Database searches identified studies of MTP outcomes conducted in US cancer care settings from 2000 to 2017. Forty-five studies met criteria for inclusion. MTP was associated with favorable effects on several indicators of cancer care quality, including delivery of guideline-concordant treatment and improvements in diagnostic accuracy, staging completeness, surgical technique, and timeliness. Effects on survival and clinical trials enrollment were mixed. Delivery formats for MTP were generally not well described, and study designs were nonrandomized, limiting the ability to identify mediators of intervention effects. Continued study is warranted to clarify effective components of MTP interventions, and to understand the mechanism(s) through which MTP produces favorable effects on outcomes.

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The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer☆

Cited by 113 publications

References 11 publications

An Official American Thoracic Society/European Respiratory Society Statement: The Role of the Pulmonologist in the Diagnosis and Management of Lung Cancer

An Official American Thoracic Society/European Respiratory Society Statement: The Role of the Pulmonologist in the Diagnosis and Management of Lung Cancer

ReCAP: Impact of Multidisciplinary Care on Processes of Cancer Care: A Multi-Institutional Study

Outcomes of multidisciplinary treatment planning in US cancer care settings

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