Mullan B J, Brown J S, Lowe D, Rogers S N, Shaw R J
Oral and Maxillofacial Surgery Department, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom; University of Liverpool, United Kingdom.
Oral and Maxillofacial Surgery Department, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Liverpool L9 7AL, United Kingdom.
Br J Oral Maxillofac Surg. 2014 Feb;52(2):128-33. doi: 10.1016/j.bjoms.2013.10.001. Epub 2013 Nov 23.
Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. A total of 105 patients with a new diagnosis of head and neck malignancy or complex benign tumour were discussed at 10 head and neck cancer MDT meetings. A single observer timed each discussion using a stopwatch, and recorded the number of discussants and the diagnosis and characteristics of each patient. Timings ranged from 15 to 480 s (8 min) with a mean of 119 s (2 min), and the duration of discussion correlated closely with the number of discussants (rs=0.63, p<0.001). The longest discussions concerned patients with advanced T stage (p=0.006) and advanced N stage (p=0.009) disease, the elderly (p=0.02) and male patients (p=0.05). Tumour site and histological findings were not significant factors in the duration of discussion. Most discussions on patients with early stage tumours were short (T1: 58% less than 60s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence.
多学科团队（MDT）会议在头颈部癌症的管理中发挥着重要作用。该疾病发病率的上升以及针对大量患者举行集中会议的趋势意味着进行有效的讨论至关重要。我们旨在评估单个高容量头颈部癌症多学科团队中的新病例，并探讨讨论每个病例所需时间、讨论者数量与病例类型之间的关系。在10次头颈部癌症多学科团队会议上，共讨论了105例新诊断为头颈部恶性肿瘤或复杂良性肿瘤的患者。一名观察员使用秒表记录每次讨论的时间，并记录讨论者的数量以及每位患者的诊断和特征。讨论时间从15秒到480秒（8分钟）不等，平均为119秒（2分钟），讨论时长与讨论者数量密切相关（rs = 0.63，p < 0.001）。最长的讨论涉及T分期晚期（p = 0.006）和N分期晚期（p = 0.009）疾病的患者、老年患者（p = 0.02）和男性患者（p = 0.05）。肿瘤部位和组织学结果不是讨论时长的显著因素。大多数关于早期肿瘤患者的讨论时间较短（T1期：58%少于60秒，平均90秒），参与讨论的人数也较少。许多患者，尤其是那些患有早期疾病的患者，所需讨论较少，他们的治疗可以根据商定的方案合理规划，这将为那些需要更多多学科投入的患者留出更多时间和资源。进一步的研究可能会突出对头颈部癌症患者的延长讨论，这可能会促使对方案和现有证据进行审查。
