title: The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with esophageal cancer.
abstract: BACKGROUND
  There is a paucity of data evaluating whether a multidisciplinary conference coordinating surgery, chemotherapy and radiation therapy translates into better patient care. This review compares the experiences of patients with esophageal cancer before and after the formation of a prospective, multidisciplinary thoracic malignancy conference (TMC).
  
  
  METHODS
  The records of patients with carcinoma of the esophagus at a tertiary care hospital were reviewed for completeness of staging, multidisciplinary evaluation before the initiation of therapy, time from pathologic diagnosis to treatment, multimodality therapy, and adherence to national treatment guidelines. Summary data were compared for patients treated before and after the TMC was initiated.
  
  
  RESULTS
  Between 2001 and 2007, 117 patients were treated before the initiation of the TMC and 138 patients within the TMC. The number of patients receiving, respectively, a complete staging evaluation (67% and 97%, p < 0.0001), multidisciplinary evaluation before therapy (72% and 98%, p < 0.0001), and adherence to National Comprehensive Cancer Network treatment guidelines (83% and 98%, p < 0.0001) all increased significantly, whereas mean days from diagnosis to treatment significantly decreased (27 and 16, respectively; p < 0.0001).
  
  
  CONCLUSIONS
  A multidisciplinary TMC increased the percentage of patients receiving complete staging, a multidisciplinary evaluation, and adherence to nationally accepted care guidelines while decreasing the interval from diagnosis to treatment significantly. While the ultimate goal of treatment is to improve patient survival, the surrogate variables examined in this review indicate that patients with esophageal cancer benefit from being evaluated in a prospective, multidisciplinary manner.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, St. Vincent Hospital, Indianapolis, IN, USA. rfreeman@corvascmds.com
authors.forename: Richard K
authors.initials: RK
authors.lastname: Freeman
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: Van Woerkom
authors.forename: Amy
authors.initials: A
authors.lastname: Vyverberg
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Ascioti
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy; D003245:Consensus Statements as Topic; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000628:therapy