Analysis of 105.000 patients with cancer: have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands

J. E.W. Walraven*, I. M.E. Desar, J. J.M. Hoeven van der, K. K.H. Aben, R. Hillegersberg van, C. R.N. Rasch, V. E.P.P. Lemmens, R. H.A. Verhoeven

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: For optimal oncological care, it is recommended to discuss every patient with cancer in a multidisciplinary team meeting (MDTM). This is a time consuming and expensive practice, leading to a growing demand to change the current workflow. We aimed to investigate the number of patients discussed in MDTMs and to identify characteristics associated with not being discussed. Methods: Data of patients with a newly diagnosed solid malignant tumour in 2015 and 2016 were analysed through the nationwide population-based Netherlands Cancer Registry (NCR). We clustered tumour types in groups that were frequently discussed within a tumour-specific MDTM. Tumour types without information about MDTMs in the NCR were excluded. Multivariable logistic regression analyses were used to analyse factors associated with not being discussed. Results: Out of 105.305 patients with cancer, 91% were discussed in a MDTM, varying from 74% to 99% between the different tumour groups. Significantly less frequently discussed were patients aged ≥75 years (odds ratio [OR] = 0.7, 95% confidence interval [CI] = 0.6–0.7), patients diagnosed with disease stage I (OR = 0.5, 95% CI = 0.5–0.6), IV (OR = 0.4, 95% CI = 0.4–0.4) or unknown (OR = 0.2, 95% CI = 0.2–0.2) and patients who received no treatment (OR = 0.3, 95% CI = 0.3–0.3). Patients who received a multidisciplinary treatment were more likely to be discussed in contrary to a monodisciplinary treatment (OR = 4.6, 95% CI = 4.2–5.1). Conclusion: In general, most patients with cancer were actually discussed in a MDTM, although differences were observed between tumour groups. Factors associated with not being discussed may, at least partially, reflect the absence of a multidisciplinary question. These results form a starting point for debate on a more durable and efficient new MDTM strategy.

Original languageEnglish
Pages (from-to)85-93
Number of pages9
JournalEuropean Journal of Cancer
Volume121
DOIs
Publication statusPublished - 1 Nov 2019

Keywords

  • Guideline adherence
  • Interdisciplinary communication
  • Multidisciplinary care
  • Neoplasms/epidemiology
  • Patient care team/ organisation and administration
  • Process assessment (health care)
  • Quality of health care

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