Multidisciplinary team care in advanced lung cancer

Kowalczyk, Anna; Jassem, Jacek

doi:10.21037/tlcr.2019.11.33

Cited by 23 publications

(29 citation statements)

References 70 publications

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“…Health governance studies on LC management suggest that integrated and multidisciplinary care reduces barriers to treatment and variation in care, improves adherence to clinical guidelines, staging, and care coordination. This strategy also significantly shortens the interval from diagnosis to treatment, and ultimately leads to a better patient experience and an increase in the quality of care for LC patients [8,9]. This review is based on previously conducted studies and does not contain any studies with human participants performed by any of the authors.…”

Section: Introductionmentioning

confidence: 99%

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

Gebbia

Guarini

Piazza³

et al. 2021

Pulm Ther

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To date, the virtual multidisciplinary tumor boards (vMTBs) are increasingly used to achieve high-quality treatment recommendations across health-care regions, which expands and develops the local MTB team to a regional or national expert network. This review describes the process of lung cancer-specific MTBs and the transition process from face-to-face tumor boards to virtual ones. The review also focuses on the project organization's description, advantages, and disadvantages. Semi-structured interviews identified five major themes for MTBs: current practice, attitudes, enablers, barriers, and benefits for the MTB. MTB teams exhibited positive responses to modeled data feedback. Virtualization reduces time spent for travel, allowing easier and timely patient discussions. This process requires a secure web platform to assure the respect of patients' privacy and presents the same unanswered prob-

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Section: Introductionmentioning

confidence: 99%

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

Gebbia

Guarini

Piazza³

et al. 2021

Pulm Ther

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“…Fourth, previous studies suggested that MDT care and treatment could significantly increase the accuracy of diagnosis, shorten the duration from diagnosis to treatment, and finally bring survival benefits to cancer patients. 26 , 27 In our case, after confirming a massive primary lesion with liver metastasis through CT-abdomen, the MDT discussion and treatment was initiated. Subsequently, a satisfactory therapeutic result was achieved through MDT efforts.…”

Section: Discussionmentioning

confidence: 80%

A Highly Responsive Pancreatic Ductal Adenocarcinoma with Liver Metastasis: A Rare Case Report

Wang

et al. 2021

IJGM

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Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most refractory and lethal cancer. The overall survival is dismal due to the high frequency of recurrence and metastasis after surgery and resistance to chemotherapy. Patients with the locally advanced or metastatic disease usually have the poorest prognosis. Herein, we report a rare highly responsive PDAC with liver metastasis. Case Presentation A 49-year-old female presented with dull abdominal and back pain, discomfort after eating, fatigue, and recent weight loss of 5 kg. Clinical examination was normal and no relevant oncological history was observed. A routine blood test showed low red blood cell count and low hemoglobin level. Markedly increased carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 125 levels were detected. Computer tomography (CT) of the abdomen revealed a massive pancreatic tumor with the invasion of almost all important surrounding blood vessels and liver metastasis. After the genetic test and percutaneous biopsy for this tumor, a multidisciplinary team (MDT) discussion was initiated. Subsequently, oral chemotherapy (S-1) and 125 I radiative seeds implantation were recommended. Surprisingly, the tumor shrank significantly after treatment. On August 14, 2019, pancreatoduodenectomy was performed. The tumor was successfully resected and liver metastasis was not detected. Based on the postoperative histopathological result, there was only fibrous tissue hyperplasia and inflammatory cell infiltration. Besides, no tumor tissue was found. Until now, through outpatient follow-up, no signs of recurrence and metastasis have been observed. Conclusion Although the therapeutic efficacy and prognosis of PDAC are dismal, we successfully cured a patient with a metastatic disease through multidisciplinary cooperation. However, the therapeutic experience should be summarized and further research should be performed to confirm whether it is appropriate for other PDAC patients.

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“…Despite the CCDSS enhancing case-relevant information for lung cancer staging and treatment selection, professionals doubted if the MDTM workflows would benefit from this system (CFIR: Characteristics of Individuals). However, previous literature suggested room for improvement in care efficacy of lung cancer MDTMS as 16% of patients failed to achieve prompt MDTM treatment decisions, mainly caused by further investigations and insufficient pathology [ 30 , 31 , 32 ]. Recently, initial evidence was reported for the potential of CDSSs in lung tumor boards as using a CDSS enabled clinicians to get to higher quality decisions compared to their normal way of working (median = 3.75 out of 5; min = 3 and max = 4) [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, as they evaluated only eight primary lung cancer cases, evidence regarding the real impact of CDSSs on MDTM parameters remains scarce. As professionals expected the CCDSS to provide insight into whether data essential for MDTM decision-making is complete (CFIR: Intervention characteristics), it would be worthwhile to assess its impact on MDTM care efficacy as this potentially shortens the interval from diagnosis to treatment and increases survival and quality of life [ 32 ]. Performing a usability test and validation prior to roll-out was highly prioritized by most professionals to become familiar with the system and to evaluate its performance (CFIR: Characteristics of Individuals, Process).…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators for Implementation of a Computerized Clinical Decision Support System in Lung Cancer Multidisciplinary Team Meetings—A Qualitative Assessment

Klarenbeek¹,

Schuurbiers-Siebers

Heuvel

et al. 2020

Biology

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Background: Oncological computerized clinical decision support systems (CCDSSs) to facilitate workflows of multidisciplinary team meetings (MDTMs) are currently being developed. To successfully implement these CCDSSs in MDTMs, this study aims to: (a) identify barriers and facilitators for implementation for the use case of lung cancer; and (b) provide actionable findings for an implementation strategy. Methods: The Consolidated Framework for Implementation Science was used to create an interview protocol and to analyze the results. Semi-structured interviews were conducted among various health care professionals involved in MDTMs. The transcripts were analyzed using a thematic analysis following a deductive approach. Results: Twenty-six professionals participated in the interviews. The main facilitators for implementation of the CCDSS were considered to be easy access to well-structured patient data, and the resulting reduction of MDTM preparation time and of duration of MDTMs. Main barriers for adoption were seen in incomplete or non-trustworthy output generated by the system and insufficient adaptability of the system to local and contextual needs. Conclusion: Using a CCDSS in lung cancer MDTMs was expected to increase efficiency of workflows. Successful implementation was seen as dependent on the reliability and adaptability of the CCDSS and involvement of key users in the implementation process.

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Multidisciplinary team care in advanced lung cancer

Cited by 23 publications

References 70 publications

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

A Highly Responsive Pancreatic Ductal Adenocarcinoma with Liver Metastasis: A Rare Case Report

Barriers and Facilitators for Implementation of a Computerized Clinical Decision Support System in Lung Cancer Multidisciplinary Team Meetings—A Qualitative Assessment

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