title: Initial impact of a systematic multidisciplinary approach on the management of patients with gastroenteropancreatic neuroendocrine tumor.
abstract: According to the international guidelines, a multidisciplinary approach is currently advised for the optimal care of patients with a gastroenteropancreatic neuroendocrine tumor (GEP NET). In our institution (tertiary care center), a systematic multidisciplinary approach was established in May 2007. In this study, we have aimed to assess the initial impact of establishing a systematic multidisciplinary approach to the management of GEP NET patients. We have collected and compared the biochemical, imaging, and pathological data and the therapeutic strategies in GEP NET patients diagnosed, treated, or followed-up from January 1993 to April 2007 versus GEP NET patients attending our institution after the multidisciplinary approach starting, from May 2007 to October 2008. Data of 91 patients before and 42 patients after the establishment of the multidisciplinary approach (total: 133 consecutive GEP NET patients) have been finally collected and analyzed. Before the establishment of the multidisciplinary approach, a lack of consistency in the biochemical, imaging, and pathological findings before treatment initiation as well as during follow-up of GEP NET patients was identified. These inconsistencies have been reduced by the systematic multidisciplinary approach. In addition, the therapeutic management of GEP NET patients has been altered by the multidisciplinary approach and became more consistent with recommended guidelines. We think that a systematic multidisciplinary approach significantly impacts on GEP NET patient care and should be established in all centers dealing with these tumors.
authors.affiliation: Department of Endocrinology & Diabetes Mellitus, St Vincent's University Hospital-University College Dublin, 4 Elm Park, Dublin 4, Ireland, gianlucatamagno@tiscali.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tamagno
authors.forename: Kieran
authors.initials: K
authors.lastname: Sheahan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Skehan
authors.forename: Justin G
authors.initials: JG
authors.lastname: Geoghegan
authors.forename: David
authors.initials: D
authors.lastname: Fennelly
authors.forename: Conor D
authors.initials: CD
authors.lastname: Collins
authors.forename: Donal
authors.initials: D
authors.lastname: Maguire
authors.forename: Oscar
authors.initials: O
authors.lastname: Traynor
authors.forename: David P
authors.initials: DP
authors.lastname: Brophy
authors.forename: Colin
authors.initials: C
authors.lastname: Cantwell
authors.forename: Niall
authors.initials: N
authors.lastname: Swan
authors.forename: Lisa
authors.initials: L
authors.lastname: McGowan
authors.forename: Dermot
authors.initials: D
authors.lastname: O'Toole
authors.forename: Donal
authors.initials: D
authors.lastname: O'Shea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D010348:Patient Care Team; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult