title: Does a multidisciplinary team approach in a tertiary referral centre impact on the initial management of head and neck cancer?
abstract: OBJECTIVE
  A multi-disciplinary team (MDT) is essential in the management of cancer. Head and neck cancer (HNC) is a rare, complex and heterogeneous group of malignancies for which different treatment options are available. However, the potential impact of MDT on the management of HNC has been only poorly evaluated to date. This study evaluates the impact of MDT on the management of HNC in a tertiary centre.
  
  
  METHODS
  We retrospectively analysed records of HNC patients referred to a MDT evaluation at the Istituto Nazionale Tumori of Milan, Italy, from May 2007 to January 2012. All cases were reviewed by a MDT consisting of a head and neck surgeon, a radiation oncologist, and a medical oncologist.
  
  
  RESULTS
  Data from 781 HNC patients were analysed. Approximately 70% of patients were referred to our Institution for a second opinion consultation. Following MDT evaluation, new staging examinations were requested in 49% of patients, and treatment plan was modified in 10%.
  
  
  CONCLUSIONS
  A MDT approach in a tertiary referral hospital leads to staging refinement of disease or changes in treatment plan in about 60% of patients.
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy. Electronic address: cristiana.bergamini@istitutotumori.mi.it.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Bergamini
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Locati
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bossi
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Granata
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alfieri
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Resteghini
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Imbimbo
authors.affiliation: Radiotherapy Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Fallai
authors.affiliation: Radiotherapy Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Orlandi
authors.affiliation: Radiotherapy Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Tana
authors.affiliation: Radiotherapy Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Nicola Alessandro
authors.initials: NA
authors.lastname: Iacovelli
authors.affiliation: Otorinolaryngol Surgery Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Guzzo
authors.affiliation: Otorinolaryngol Surgery Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Tullio
authors.initials: T
authors.lastname: Ibba
authors.affiliation: Otorinolaryngol Surgery Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Sarah
authors.initials: S
authors.lastname: Colombo
authors.affiliation: Otorinolaryngol Surgery Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianchi
authors.affiliation: Otorinolaryngol Surgery Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Natalia
authors.initials: N
authors.lastname: Pizzi
authors.affiliation: Otorinolaryngol Surgery Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Fontanella
authors.affiliation: Head and Neck Unit, Istituto Nazionale Tumori, Milan, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Licitra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D012017:Referral and Consultation; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000458:organization & administration*; D055815:Young Adult
keywords: Guidelines; Head and neck cancer; Multidisciplinary team; Second opinion; Treatment plan