|LETTER TO THE EDITOR
|Year : 2014 | Volume
| Issue : 4 | Page : 495
Multidisciplinary team meetings for optimal management of cancer patients: A must?
G Aggarwal, MK Roy
Department of Surgical Oncology (GI Surgery), Tata Medical Center, New Town, Kolkata, West Bengal, India
|Date of Web Publication||1-Feb-2016|
Dr. G Aggarwal
Department of Surgical Oncology (GI Surgery), Tata Medical Center, New Town, Kolkata, West Bengal
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Aggarwal G, Roy M K. Multidisciplinary team meetings for optimal management of cancer patients: A must?. Indian J Cancer 2014;51:495
We would like to draw the attention of the oncological fraternity to the established, but minimally practiced concept of multidisciplinary team meetings (MDTs).
MDTs in cancer hospitals or tumour boards are a group of dedicated personnel aimed at optimizing the management of cancer patients in an integrated manner.
They are necessary in order to standardize cancer care, to ensure timely and appropriate attention from skilled professionals as well as to enable patients to receive the best levels of management in a consistent manner.  The team usually comprises of surgeons, oncologists, radiologists, pathologists, nurses and an MDT co-ordinator.
Lamb et al. in the only prospective study to quantify the efficacy of MDT meetings, until date, attempted to assess MDT related variables such as the quality of presented information, case positioning, timing, team size, member's contribution to discussion as well as the ability to reach clinical decisions. They concluded that accurately presented case histories formed the backbone for discussion, maximal contribution to the discussion was from the surgeon and cases presented early were discussed in a more detailed manner with higher attendance among the group. Thus, this study laid the foundation for structuring of MDTs.
Ke et al. attempted to assess the cost effectiveness of these MDT meetings vis-à-vis cancer and non-cancer care. They however failed to conclude on the same due to lack of evidence as well as a high degree of bias.
Nevertheless, the importance of structured MDT meetings especially in the domain of cancer therapy cannot be over emphasized. MDTs provide a forum for shared decision making, in particular for complex cases, where the entire onus of the decision doesn't lie with the surgeon alone and a holistic approach to a patient's management is attainable.
Further points of interest remain the frequency of these MDT sessions, the clinical background of the attendees, the accurate structuring of these meetings as well as assessment of their cost-effectiveness and logistic issues in their maintenance. A novel concept in this regard is the virtual MDT, which still needs further supportive evidence to overhaul the traditional "in attendance" concept of MDTs.
However, in the present scenario, until further evidence emanates against them, it can be safely said that the "face-to-face" MDTs remain mandatory, especially in the clinical setting for optimal oncology care.
| » References|| |
Taylor C, Munro AJ, Glynne-Jones R, Griffith C, Trevatt P, Richards M, et al
. Multidisciplinary team working in cancer: What is the evidence? BMJ 2010;340:c951.
Lamb BW, Sevdalis N, Benn J, Vincent C, Green JS. Multidisciplinary cancer team meeting structure and treatment decisions: A prospective correlational study. Ann Surg Oncol 2013;20:715-22.
Ke KM, Blazeby JM, Strong S, Carroll FE, Ness AR, Hollingworth W. Are multidisciplinary teams in secondary care cost-effective? A systematic review of the literature. Cost Eff Resour Alloc 2013;11:7.
Munro AJ, Swartzman S. What is a virtual multidisciplinary team (vMDT)? Br J Cancer 2013;108:2433-41.