The Value of Multidisciplinary Team Meetings for Patients with Gastrointestinal Malignancies: A Systematic Review.
BACKGROUND
The incidence of gastrointestinal (GI) cancer is rising and most patients with GI malignancies are discussed by a multidisciplinary team (MDT). We performed a systematic review to assess whether MDTs for patients with GI malignancies can correctly change diagnosis, tumor stage and subsequent treatment plan, and whether the treatment plan was implemented.


METHODS
We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted a search of the PubMed, MEDLINE and EMBASE electronic databases, and included studies relating to adults with a GI malignancy discussed by an MDT prior to the start of treatment which described a change of initial diagnosis, stage or treatment plan. Two researchers independently evaluated all retrieved titles and abstracts from the abovementioned databases.


RESULTS
Overall, 16 studies were included; the study quality was rated as fair. Four studies reported that MDTs changed the diagnoses formulated by individual physicians in 18.4-26.9% of evaluated cases; two studies reported that MDTs formulated an accurate diagnosis in 89 and 93.5% of evaluated cases, respectively; nine studies described that the treatment plan was altered in 23.0-41.7% of evaluated cases; and four studies found that MDT decisions were implemented in 90-100% of evaluated cases. The reasons for altering a treatment plan included the patient's wishes, and comorbidities.


CONCLUSIONS
MDT meetings for patients with a GI malignancy are responsible for changes in diagnoses and management in a significant number of patients. Treatment plans formulated by MDTs are implemented in 90-100% of discussed patients. All patients with a GI malignancy should be discussed by an MDT.
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. y.l.basta@amc.nl.
Yara L
YL
Basta
Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands.
Sifra
S
Bolle
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Paul
P
Fockens
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. k.m.tytgat@amc.nl.
Kristien M A J
KMAJ
Tytgat
D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D009367:Neoplasm Staging; D010347:Patient Care Planning; D010348:Patient Care Team