title: Result of the implementation of multidisciplinary teams in rectal cancer.
abstract: OBJECTIVE
  In 2003 colorectal multidisciplinary teams (MDTs) were established in all major Danish hospitals treating colorectal cancer. The aim was to improve the prognosis by multidisciplinary evaluation and decision about surgical and oncological treatment, based on medical history, clinical examination, imaging, histology and comorbidity. The present study evaluates the effect of the introduction of colorectal MDTs on 1 August 2004 in two Danish hospitals.
  
  
  METHODS
  A retrospective cohort study was conducted comparing the outcome during the last 3 years before introduction of MDTs with the first 2 years after (the MDT cohort). The national colorectal cancer database, with follow-up recorded by the National Patient Registry in September 2010 was used. The end-points included the incidence of preoperative radiochemotherapy offered according to the national guidelines, R0/R1/R2 resection, postoperative mortality, local recurrence, distant recurrence and over-all and disease-free survival.
  
  
  RESULTS
  Eight hundred and eleven patients were diagnosed with primary rectal cancer in Hvidovre and Bispebjerg hospitals between 1 May 2001 and 31 August 2006. The frequency of preoperative MRI scans increased in the MDT cohort and perioperative mortality decreased. More metachronous distant metastases were found in the MDT cohort but there was no difference in overall survival.
  
  
  CONCLUSIONS
  There was an improved postoperative mortality but no other potential benefits for the patients were seen after the implementation of colorectal MDTs.
authors.affiliation: Department of Surgery, Bispebjerg Hospital, Copenhagen, Denmark. pwil0002@bbh.regionh.dk
authors.forename: P
authors.initials: P
authors.lastname: Wille-Jørgensen
authors.forename: P
authors.initials: P
authors.lastname: Sparre
authors.forename: A
authors.initials: A
authors.lastname: Glenthøj
authors.forename: S
authors.initials: S
authors.lastname: Holck
authors.forename: L
authors.initials: L
authors.lastname: Nørgaard Petersen
authors.forename: H
authors.initials: H
authors.lastname: Harling
authors.forename: H
authors.initials: H
authors.lastname: Stub Højen
authors.forename: S
authors.initials: S
authors.lastname: Bülow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant; D003718:Denmark; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010348:Patient Care Team; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome