Examining the potential relationship between multidisciplinary cancer care and patient survival: an international literature review.
OBJECTIVE
The aim of this review is to examine the relationship between multidisciplinary cancer care and patient survival.


METHODS
A literature review was undertaken between January 1950 and September 2009. Included studies described multidisciplinary cancer care and its relation to patient survival. Multidisciplinary care was defined as involvement of a team of clinical and allied specialists whose intent is individualized patient management. Studies were critically appraised for internal and external validity. All study designs were included.


RESULTS
Twenty-one studies met eligibility criteria for this review, including two systematic reviews, one abstract, and 18 original studies. Pooling of results was not possible due to heterogeneity of patient populations, disease sites, measured outcomes, and follow-up periods. Twelve studies (one prospective and six retrospective cohort studies, five before-after series) reported statistically significant association between multidisciplinary care and patient survival.


CONCLUSIONS
Due to methodological limitations, this review is unable to assert a causal relationship between multidisciplinary care and patient survival. In order to better evaluate this relationship, the oncology community must first accept a common definition of multidisciplinary care. Future efforts can then elucidate which aspects of multidisciplinary care impact survival, with consideration of confounding patient and tumour factors.
Hong
Nicole J Look
NJ
Department of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. n.lookhong@utoronto.ca
Wright
Frances C
FC
Gagliardi
Anna R
AR
Paszat
Lawrence F
LF
D006801:Humans; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D010348:Patient Care Team; D016019:Survival Analysis