title: Building the multidisciplinary team for management of patients with hepatocellular carcinoma.
abstract: Optimal care of the patient with hepatocellular carcinoma (HCC) necessitates the involvement of multiple providers. Because the patient with HCC often carries 2 conditions with competing mortality risks (cancer and underlying cirrhosis), no single provider is equipped to deal with all of these patients' needs adequately. Multidisciplinary teams (MDTs) have evolved to facilitate care coordination, reassessments of clinical course, and nimble changes in treatment plans required for this complex group of patients. Providers or sites that elect to manage patients with HCC thus are increasingly aware of the need to build their own MDT or communicate with an established one. The availability of new communication technologies, such as teleconferencing or teleconsultation, offers the possibility of MDT expansion into underserved or rural areas, as well as areas such as correctional facilities. Although the availability of resources for HCC patient care varies from site to site, construction of an MDT is possible in a wide spectrum of clinical practices, and this article suggests a blueprint for assembly of such collaboration. Research strategies are needed to explain how MDTs improve clinical outcomes so that MDTs themselves can be improved.
authors.affiliation: Department of Medicine, Division of GI and Hepatology, Oregon Health and Science University, Portland, Oregon. Electronic address: nauglers@ohsu.edu.
authors.forename: Willscott E
authors.initials: WE
authors.lastname: Naugler
authors.affiliation: Division of Transplantation Surgery, Tampa General Hospital, Tampa, Florida.
authors.forename: Angel E
authors.initials: AE
authors.lastname: Alsina
authors.affiliation: Liver Transplantation, Center for Organ and Cell Transplantation, Scripps Clinic, San Diego, California.
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Frenette
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, California.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rossaro
authors.affiliation: Piedmont Transplant Institute, Piedmont Hospital, Atlanta, Georgia.
authors.forename: Marty T
authors.initials: MT
authors.lastname: Sellers
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D033183:Interdisciplinary Communication; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration*
keywords: HCC; Hepatocellular Carcinoma; Liver Cancer; Multidisciplinary Team