Improving outcomes in urological cancers: the impact of "multidisciplinary team meetings".
BACKGROUND
In order to improve the outcomes of urological cancers, guidelines published by the National Institute of Clinical Excellence encourage the management of cancer patients by specific Multi-Disciplinary Teams (MDTs) with discussion of cancer patients at MDT Meetings. The aim of this prospective study was to examine the changes in management resulting from review at MDT Meetings in our unit.


METHODS
Over a six month period 124 cancer cases were discussed at 10 meetings. Prior to the meetings consultants completed a form stating their proposed management and whether they thought this would be changed after discussion. At the meeting histological, radiological and clinical data were reviewed and a collective decision about the optimal treatment was made. Any changes were recorded.


RESULTS
Two of 124 cases had their clinical management changed as a result of the meeting. These were identified (amongst 10 others) as potential 'change cases' prior to the meeting. Four changes were made to histological reports and 1 to radiology; none of these affected clinical management.


CONCLUSIONS
Discussion of cancer cases at MDMs made no difference to the clinical management in over 98% of cases. Consultants correctly identified cases requiring discussion, indicating that a selective rather than blanket approach would be appropriate. This has the potential to reduce the considerable costs involved without affecting patient care.
Acher
Peter L
PL
William Harvey Hospital, Department of Urology, Ashford, Kent, TN24 0L2, UK. peter.acher@gstt.nhs.uk
Young
Anthony J
AJ
Etherington-Foy
Russell
R
McCahy
Philip J
PJ
Deane
Anthony M
AM