title: Impact of a multidisciplinary tumour board meeting for upper-GI malignancies on clinical decision making: a prospective cohort study.
abstract: OBJECTIVE
  The Dutch guidelines for diagnosis and treatment of upper-GI malignancies recommend review of patients by a multidisciplinary tumour board (MDT). The purpose of this study was to determine the effect on clinical decision making of an MDT for patients with upper-GI malignancies.
  
  
  METHODS
  All physicians participating in the MDT completed an electronic standardised case form to delineate their proposed treatment plan for the patients they presented, including the intent of treatment and the modality of treatment. This therapeutic or diagnostic proposal was then compared with the plan on which consensus was reached by the MDT.
  
  
  RESULTS
  A total of 252/280 (90.0%) forms were completed and suitable for analysis. In 87/252 (34.5%) of the case presentations, the MDT altered the proposed plan of management. In 29/87 (33.3%) cases, a more extensive diagnostic work-up was decided upon. In 8/87 (9.2%) cases the curative intent of the proposed treatment was altered to palliation only. In 2/75 (2.7%) cases, however, it was decided that a patient could be treated with curative intent instead of the proposed palliative intent.
  
  
  CONCLUSIONS
  In over 1/3 of cases, the diagnostic work-up or treatment plan is altered after evaluation by a multidisciplinary tumour board. This study supports Dutch guidelines recommending discussion of patients with upper-GI malignancies by a multidisciplinary tumour board.
authors.affiliation: Department of Surgery, Erasmus Medical Centre, Room Z-836, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. p.vanhagen@erasmusmc.nl
authors.forename: Pieter
authors.initials: P
authors.lastname: van Hagen
authors.forename: Manon C W
authors.initials: MC
authors.lastname: Spaander
authors.forename: Ate
authors.initials: A
authors.lastname: van der Gaast
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Rij
authors.forename: Hugo W
authors.initials: HW
authors.lastname: Tilanus
authors.forename: J Jan B
authors.initials: JJ
authors.lastname: van Lanschot
authors.forename: Bas P L
authors.initials: BP
authors.lastname: Wijnhoven
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy*; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D058025:Interdisciplinary Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies