Do Surgical Oncology Multidisciplinary Team Meetings Make a Difference?

Eden A Smith; Jesse D Ey; Vishak Senthil; Antonio Barbaro; Suzanne Edwards; Emma L Bradshaw; Guy J Maddern

doi:10.1245/s10434-024-16471-7

Do Surgical Oncology Multidisciplinary Team Meetings Make a Difference?

Ann Surg Oncol. 2024 Nov 16. doi: 10.1245/s10434-024-16471-7. Online ahead of print.

Authors

Eden A Smith¹, Jesse D Ey¹, Vishak Senthil¹, Antonio Barbaro¹, Suzanne Edwards², Emma L Bradshaw¹, Guy J Maddern³

Affiliations

¹ Department of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Woodville, Australia.
² School of Public Health, The University of Adelaide, Adelaide, Australia.
³ Department of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Woodville, Australia. guy.maddern@adelaide.edu.au.

PMID: 39550481
DOI: 10.1245/s10434-024-16471-7

Abstract

Background: Multidisciplinary team (MDT) meetings are important but resource-expensive components of surgical and oncologic care. This cohort study investigated the effectiveness of surgical MDT meetings by assessing the predictability of MDT meeting recommendations, the degree that patient management plans are changed by discussion, and the incidence of recommendation implementation.

Methods: Multidisciplinary team meetings at The Queen Elizabeth Hospital in South Australia were audited for upper gastrointestinal (UGI) and colorectal (CR) surgical units from August 2021 to June 2022. All cases referred for MDT meeting discussion were included. Prospectively obtained pre-MDT meeting management plans were compared with formal MDT meeting recommendations to assess for concordance and degree of change. Patient records were assessed after 8 months for MDT meeting recommendation implementation. Multivariable analysis of patient factors was performed to identify associations between MDT meeting recommendation predictability and implementation.

Results: In 438 patient cases, discussed during 30 MDT meetings, 317 (72.37%) were correctly predicted. Specifically, 226 (51.6%) were correct with no change, 28 (6.39%) were correct with minor changes, 40 (9.13%) were correct with moderate changes, and 23 (5.25%) were correct with major changes. The UGI and CR cohorts differed significantly in moderate changes (P = 0.0217). The female patients were 1.62 times more likely than the male patients to have pre-MDT meeting management plans predicted (P = 0.0201). Formal MDT meeting recommendations were implemented in 380 (89.62%) cases.

Conclusions: The MDT meetings changed management for almost 1 in 2 patients discussed. Other than female sex, no identifiable patient factors increased the likelihood of predictability, and no factors predicted recommendation implementation.

Keywords: Colorectal; Multidisciplinary team meeting; Oncology; Patient care team; Sex discordance; Surgery; Treatment; Tumour board; Upper gastrointestinal.