Effect of multidisciplinary team care on the risk of recurrence in breast cancer patients: A national matched cohort study

Abstract

Background Cancer has been the leading cause of death in the past decade in Taiwan, with breast cancer being the most common type of cancer in females. Very few studies looked at the risk of recurrence in patients who received multidisciplinary team (MDT) care. We analyzed the influence of MDT on the risk of recurrence and death in breast cancer patients. Method In this retrospective study, we included newly diagnosed patients from 2004 to 2010. The study included 9,266 breast cancer patients who were enrolled in MDT care and 9,266 patients who were not. The study used log-rank test to analyze patients’ characteristics, hospital characteristics, cancer staging, and treatment methods to compare the recurrence rates in MDT care and non-MDT care participants. We used Cox proportional hazards model to examine the effect of MDT and associated factors on the risk of recurrence and mortality of breast cancer patients. Results Relative risk of recurrence was lower for patients who received MDT care than for patients who did not (HR, 0.84; 95%CI: 0.70–0.99) after matching. The mortality risk for breast cancer patients with relapse was 8.48 times (95%CI: 7.53–9.54) than that for patients without relapse. Conclusions The relative risk of recurrence and death was significantly lower for breast cancer patients who received MDT care than for those who did not. We suggest that MDT care be implanted in the National Health Policy settings of breast cancer patients.

The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

“…Forty-one articles investigated the effect of MDTMs on cancer care pathways in colorectal cancer (21/41) , lung cancer (10/41) [38][39][40][41][42][43][44][45][46][47], prostate cancer (6/41) [48][49][50][51][52][53] and breast cancer (4/41) [54][55][56][57] (Table 1). All studies were conducted in adults (total n = 82,073, range 42-32,569 study subjects per study, mean 2002), with studies originating from in Oceania (8/41) [20,26,29,38,39,43,45,52], Asia (9/41) [18,21,23,35,41,46,50,56,57], Europe (13/41) [17,19,24,25,27,31,32,34,36,37,44,…”

“…All studies were conducted in adults (total n = 82,073, range 42-32,569 study subjects per study, mean 2002), with studies originating from in Oceania (8/41) [20,26,29,38,39,43,45,52], Asia (9/41) [18,21,23,35,41,46,50,56,57], Europe (13/41) [17,19,24,25,27,31,32,34,36,37,44,48,49], North America (10/41) [22,28,30,33,40,42,47,51,53,54] or Africa (1/41) [55]. Studies were performed in multicenter (6/41) [34,37,38,40,41,56] or single-center (35/41) [17][18]…”

“…The frequency of MDTMs ranged from 4 times a week [21], to weekly [17,19,20,[22][23][24][25]29,[33][34][35][36]38,39,[42][43][44][45][46]49,[52][53][54][55] to biweekly [26,28,30,40,47,48]. Ten articles provided limited or no information on the frequency of MDTMs [18,27,31,32,37,41,50,51,56,57]. The outcomes measured in the articles were changes in or differences between: (1) process outcomes (9/41), (2) patient management (34/41) and (3) patient outcomes (18/41).…”

“…The outcomes measured in the articles were changes in or differences between: (1) process outcomes (9/41), (2) patient management (34/41) and (3) patient outcomes (18/41). Studies using a before-after study design (12/41) [17,23,24,26,28,32,[34][35][36]44,46,55] or a casecontrol study design (13/41) [18,20,25,27,31,33,[37][38][39][40]43,47,56] investigated a combination of all three outcome groups. When a cohort study design (16/41) [19,21,22,29,30,41,42,45,[48][49][50][51][52][53][54]57] was used, most investigated patient management (13/16).…”

Challenging cases in oncofertility: insights from a national specialized e-meeting for fertility preservation specialists

“…MDT meetings have now become an important component for the management of numerous conditions (e.g., diabetes, cardiovascular diseases, bariatric surgery, rare tumours, endometriosis), which requires stakeholders from different fields of expertise [20][21][22]. Studies report that MDT meetings improve the decision-making process, coordination between physicians, and patient outcomes [23][24][25]. In rare diseases or tumours, MDT meetings also provide high-level expertise, pooling experiences, and knowledge of highly specialized physicians in a specific field [26,27].…”