Background:
Since the publication of National Service Improvement Framework for Cancer, multidisciplinary team meetings (MDTM) have been highlighted as an essential component in the management of patients with cancer. Currently, there is no published data detailing the utility and outcomes of a MDTM on the management of colorectal cancer (CRC).
Purpose:
To examine the impact of an MDTM review (pathology, radiology and subsequent clinician discussion) on patient care at a major tertiary health service.
Methods:
All patients discussed at the Monash Health CRC MDTM over a six month period (August 2014-January 2015) were prospectively reviewed. Radiology and pathology reviews were checked against the original reports and changes noted. The subsequent clinical discussions were reviewed in light of the changed reports and the impact of the changes on patient management were categorised into nil, minor and major impact.
Results:
150 patients were discussed over the six month period (17 patients for pathology, 44 for radiology and the remaining 89 had both reviewed). Changes were made in 26 cases (17.3%) – 11 pathology, 14 radiology and both were changed in one case.
The impact of the 26 changes was categorised as nil in one case, minor in 13 and major in 12. Of the 12 major changes, 9 were changes to radiology and 3 to pathology.
The most common changes in the 26 cases were changes to TMN staging (20 cases total; 10 T, 6 N, 4 M), margin involvement (2 cases) and vascular invasion (2 cases).
Conclusion:
Discussion of patients at a CRC MDTM prompted a change in investigation reporting in 17% of cases. This prompted a major change in management plan in 46% of these cases, thus highlighting the importance of the MDT in patient care.