title: Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study.
abstract: In Taiwan, cancer is the top cause of death, and the mortality rate of lung cancer is the highest of all cancers. Some studies have demonstrated that multidisciplinary team (MDT) care can improve survival rates of non-small cell lung cancer (NSCLC) patients. However, no study has discussed the effect of MDT care on different stages of NSCLC. The target population for this study consisted of patients with NSCLC newly diagnosed in the 2005-2010 Cancer Registry. The data was linked with the 2002-2011 National Health Insurance Research Database and the 2005-2011 Cause of Death Statistics Database. The multivariate Cox proportional hazards model was used to explore whether the involvement of MDT care had an effect on survival. This study applied the propensity score as a control variable to reduce selection bias between patients with and without involvement of MDT care. The adjusted hazard ratio (HR) of death of MDT participants with stage III & IV NSCLC was significantly lower than that of MDT non-participants (adjusted HR = 0.87, 95% confidence interval = 0.84-0.90). This study revealed that MDT care are significantly associated with higher survival rate of patients with stage III and IV NSCLC, and thus MDT care should be used in the treatment of these patients.
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan; Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Chien-Chou
authors.initials: CC
authors.lastname: Pan
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan.
authors.forename: Pei-Tseng
authors.initials: PT
authors.lastname: Kung
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: Yueh-Hsin
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan.
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Chang
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: Shih-Ting
authors.initials: ST
authors.lastname: Wang
authors.affiliation: Department of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D015996:Survival Rate; D013624:Taiwan; D016896:Treatment Outcome