MDT practice determines treatment pathway for patients with advanced
ovarian cancer: a multi-centre observational study
Abstract
Background Patients presenting with advanced ovarian cancer can be
managed in a variety of ways. No clear selection algorithms exist to
guide decision-making and there is significant geographical variation in
practice. Decision-making takes place in specialist multidisciplinary
team meetings (MDTs). We wanted to examine whether format and behaviour
within these meetings could explain the geographical variation in
treatment patterns seen in England Methods Observational study of five
cancer centre MDTs over a six-week period. Data were recorded for
overall MDT performance. The GO-MDT-MODe tool was used to provide a
measure of participation and quality of case discussion for all cases of
advanced ovarian cancer. MDT scores were correlated with surgical and
survival data extracted from national audit data. Results A total of 870
case discussions, including 145 cases of advanced ovarian cancer, were
observed. MDTs varied in structure, format and time allocation between
centres. Cluster analysis showed significant variation in quality and
participation of discussion between centres (p<0.0025) and
this correlated with the proportion of patients in the wider cancer
alliance undergoing surgery, but not with overall survival Conclusions
We have shown that at least part of the variation in practice seen in
the UK correlates with different behaviours within MDTs. Increasing time
for discussion and encouraging participation from all staff groups may
increase proportions of patients undergoing optimal treatment regimens.