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The role of multi-disciplinary teams in decision

The role of multi-disciplinary teams in decision making for patients with recurrent malignant disease.

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The role of multi-disciplinary teams in decision

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  1. The role of multi-disciplinary teams in decision making for patients with recurrent malignant disease S Strong 1,2, NS Blencowe1,2,T Fox1, C Reid3 , T Crosby4, H.Ford5, J M Blazeby1,21School of Social and Community Medicine, Canynge Hall, University of Bristol, Bristol UK.2Division of Surgery, Head & Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.3Division of Specialised Services, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.4Velindre NHS Trust, Unit 2 Charnwood Court, Nantgarw, Cardiff5Addenbrooke’s Department of Oncology & Cambridge Cancer Trials Centre, Cambridge

  2. MDT meetings • Picture of mdt team

  3. UGI cancer survival 1. Allum et al. Journal of Clinical Oncology. 2009

  4. Aims • investigate role MDT in decision-making for patients with disease recurrence • Consider how issues addressed nationally

  5. Methods • Sequential MDT records screened • Patients with possible recurrence identified • Notes reviewed and info recorded about: • symptoms • reason for referral & source • treatment decision & implementation

  6. Results Patients discussed n=304 • 54 MDT meetings, • 1181 discussions about 304 pts • Recurrence confirmed in 29 pts Suspected recurrence n=34 Confirmed recurrence n=29 Local n=19 Mets n=9

  7. Results, n=29 • Mostly surgical referrals (n=25) • Symptoms pain (n=8), dysphagia (n=7), weight loss (n=7)

  8. Results, n=29 • MDT treatment decisions, best supportive care (n=10), chemo (n=9), stent (n=5), radio (n=3), surgery (n=2) • 19 (65.5%) reviewed by oncologist after MDT

  9. Results, n=29 • 25 (86.2%) recommendations implemented • Reasons for non-implementation were; declining health (n=2) patient preference (n=2)

  10. Summary • 29 patients (9%) of new MDT patients • recurrence discussed • Majority 19 (66%) were offered further • treatments and all received CNS support • Pts with recurrence benefit from MDT

  11. Implications • Should discussion of pts with recurrence at MDT be mandatory? • Uncertain which type of MDT is optimal

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