Improving outcomes in lung cancer: the value of the multidisciplinary health care team

Figures & data

Table 1 Key studies pertaining to multidisciplinary care and outcomes in lung cancer

Study	Design	Participants	Aims	Results
Bydder et al^Citation7	Prospective observational single center	98 with inoperable NSCLC	Comparison of those discussed and not discussed at MDT over 12 months	Improved survival in those discussed at MDT 280 vs 205 days (P=0.048)
Forrest et al^Citation10	Retrospective observational single center	323 with inoperable NSCLC	Comparison of two cohorts before and after MDT introduction	Improved use of chemotherapy (23% vs 7%) and survival 6.6 vs 3.2 months (P<0.001) in those after introduction of MDT
Kehl et al^Citation25	Prospective observational multicenter	4,620 with lung or colorectal cancer	Comparison of those treated by physicians attending different styles of MDTs	Regular physician tumor-board involvement was associated with clinical trial participation (OR 1.6, 95% CI 1.1–2.2) and resection rates (OR 2.9, 95% CI 1.3–6.8), but not overall survival
Salomaa et al^Citation17	Retrospective observational single center	132 lung cancer hospital patients	Examine for presence and causes of delays in the diagnosis and treatment of lung cancer	Multiple reasons were found for diagnostic delays in lung cancer that maybe improved by a multidisciplinary approach
Keating et al^Citation47	Observational	All cancer patients diagnosed or treated at VA hospitals	Association of tumor boards with outcomes adjusted for patient and clinical parameters	Tumor boards associated with increased radiation therapy for early stage lung cancer not undergoing surgery; those with stage IIIA disease not surgically managed or with limited small-cell lung cancer were more likely to undergo chemoradiotherapy
Lamb et al^Citation11	Systematic review	37 studies included, most poor quality	Assessed quality of MDT care decisions	MDTs changed cancer management in 2%–52% of cases; failure to reach decision in 27%–52% cases, patient preferences not discussed; multiple barriers to good MDT care identified

Abbreviations: NSCLC, non-small-cell lung cancer; MDT, multidisciplinary team; OR, odds ratio; CI, confidence interval; VA, US Veterans Affairs.

BydderSNowakAMarionKPhillipsMAtunRThe impact of case discussion at a multidisciplinary team meeting on the treatment of survival of patients with inoperable non-small cell lung cancerIntern Med J20093983884120233244

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ForrestLMcMillanDMcArdleCDunlopDAn evaluation of the impact of a multidisciplinary team, in a single centre, on treatment and survival in patients with inoperable non-small-cell lung cancerBr J Cancer20059397797816234818

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KehlKLLandrumMBKahnKLGraySWChenABKeatingNLTumor board participation among physicians caring for patients with lung or colorectal cancerJ Oncol Pract201511e267e27825922221

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SalomaaESällinenSHiekkanenHLiippoKDelays in the diagnosis and treatment of lung cancerChest20051282282228816236885

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KeatingNLLandrumMBLamontEBBozemanSRShulmanLNMcNeilBJTumor boards and the quality of cancer careJ Natl Cancer Inst2013105211312123274388

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LambBBrownKNagpalKVincentCGreenJSevdalisNQuality of care management decisions by multidisciplinary cancer teams: a systematic reviewAnn Surg Oncol2011182116212521442345

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