A single-institution prospective evaluation of a neuro-oncology multidisciplinary team meeting. (October 2018)

• Record Type: Journal Article
• Authors: Ameratunga, Malaka; Miller, Dorothea; Ng, Wayne; Wada, Mori; Gonzalvo, Augusto; Cher, Lawrence; Gan, Hui K.
• Is Part Of: Journal of clinical neuroscience. Volume 56(2018)
• Page Start: 127
• Page End: 130
• Publication Date: 2018-10
• Subjects: Multidisciplinary team meeting -- Tumour board -- Neuro-oncology; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2018.06.032
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Many cases (35%) in neuro-oncology MDTs have substantial treatment plan changes. Treatment decisions made at neuro-oncology MDTs are largely adhered to. Treatment plan changes were associated with longer discussion time at MDTs. Abstract: Multi-disciplinary team meetings (MDTs) are considered essential to quality cancer care. For some malignancies, MDTs have been associated with improved outcomes, but data regarding the neuro-oncology MDT is limited. We prospectively described the MDT at our institution and evaluated its impact on clinical management. Cases were discussed amongst the treating team and a pre-MDT plan and reason for discussion (RFD) was documented before the MDT. Patient specific clinical data was captured prospectively, with further pathological and radiological information captured during the MDT. Subsequently, the MDT consensus decision was recorded. High impact decisions (HID) were those in which the pre-MDT plan was substantially modified. A HID rate of >10% was considered clinically significant. Adherence to MDT recommendations was recorded. Seventy-nine cases were discussed at the MDT. Fifty-two cases (66%) were male. The median age was 53 (17–84). Thirty-three cases were new diagnoses and the remainder were relapsed/progressive disease. Thirty-nine cases were primary brain tumours, 25 were metastatic tumours and 15 were other. Twenty-eight (35%) had HID. No RFDs were statistically significantly associated with a HID (p = 0.265). Adherence data was collected for 95% (75) of cases. Treatment concordance with the MDT plan occurred in 90% (67) of cases. For cases of non-concordance, six out of eight (75%) were due to patient choice. Overall, a clinically significant proportion of treatment modifications are made at the neuro-oncology MDT. There were no case types which did not benefit from MDT discussion. MDT recommendations were largely adhered to, and in cases of non-concordance, were largely due to patient choice.