title: Improving care for patients with oesophageal and gastric cancer: impact of a statewide multidisciplinary team.
abstract: BACKGROUND
  To standardize management of upper gastrointestinal (GI) cancer in South Australia, a statewide video linked multidisciplinary team (MDT) meeting was established in late 2009. Although cancer MDTs are recognized as a standard of care, it is important to audit their impact.
  
  
  METHODS
  A retrospective audit of MDT outcomes and recommendations for patients reviewed by the upper GI MDT between 1 January 2010 and 31 December 2011 was undertaken. The proportion of patients with new upper GI malignancies reviewed and the proportion reviewed within 2 weeks of diagnosis were determined. Recommendations from the MDT meetings regarding treatment intent, management, investigations and trial participation were audited.
  
  
  RESULTS
  From 2010 to 2011, the proportion of newly diagnosed upper GI malignancies in South Australia reviewed by the MDT increased from 43.2% to 54.3%. More oesophageal than gastric cancer cases were reviewed by the MDT. The proportion of patients reviewed within 2 weeks of diagnosis increased from 20% to 50%. The proportion of patients referred for neoadjuvant or definitive chemoradiotherapy increased from 2010 to 2011. Fifty per cent of all patients reviewed were recommended to have further investigations. Recommendations for clinical trial participation increased from 0% in 2010 to 11% in 2011.
  
  
  CONCLUSIONS
  A statewide upper GI cancer MDT is feasible. Implementation of the MDT was followed by an increase in the number of patients reviewed and the proportion reviewed within 2 weeks of diagnosis. Greater awareness of the MDT and access to it may be required to continue to increase the proportion of cancers reviewed.
authors.affiliation: Department of Surgery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Eleanor E
authors.initials: EE
authors.lastname: Wilson
authors.affiliation: Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Thompson
authors.affiliation: Department of Surgery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Jeff
authors.initials: J
authors.lastname: Bull
authors.affiliation: Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Jones
authors.affiliation: Department of Medical Oncology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
authors.forename: Timothy
authors.initials: T
authors.lastname: Price
authors.affiliation: Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Devitt
authors.affiliation: Department of Surgery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: David I
authors.initials: DI
authors.lastname: Watson
authors.affiliation: Department of Surgery, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Tim
authors.initials: T
authors.lastname: Bright
mesh_terms: D003657:Decision Making; D019468:Disease Management; D004938:Esophageal Neoplasms / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D010347:Patient Care Planning / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*; D012189:Retrospective Studies; D013021:South Australia; D059039:Standard of Care / Q000639:trends*; D013274:Stomach Neoplasms / Q000628:therapy*
keywords: esophageal cancer; gastric cancer; multidisciplinary communication; upper gut