Wilson Eleanor E, Thompson Sarah K, Bull Jeff, Jones Bronwyn, Price Timothy, Devitt Peter G, Watson David I, Bright Tim
Department of Surgery, Flinders University, Adelaide, South Australia, Australia.
Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
ANZ J Surg. 2016 Apr;86(4):270-3. doi: 10.1111/ans.12869. Epub 2014 Oct 7.
To standardize management of upper gastrointestinal (GI) cancer in South Australia, a statewide video linked multidisciplinary team (MDT) meeting was established in late 2009. Although cancer MDTs are recognized as a standard of care, it is important to audit their impact.
A retrospective audit of MDT outcomes and recommendations for patients reviewed by the upper GI MDT between 1 January 2010 and 31 December 2011 was undertaken. The proportion of patients with new upper GI malignancies reviewed and the proportion reviewed within 2 weeks of diagnosis were determined. Recommendations from the MDT meetings regarding treatment intent, management, investigations and trial participation were audited.
From 2010 to 2011, the proportion of newly diagnosed upper GI malignancies in South Australia reviewed by the MDT increased from 43.2% to 54.3%. More oesophageal than gastric cancer cases were reviewed by the MDT. The proportion of patients reviewed within 2 weeks of diagnosis increased from 20% to 50%. The proportion of patients referred for neoadjuvant or definitive chemoradiotherapy increased from 2010 to 2011. Fifty per cent of all patients reviewed were recommended to have further investigations. Recommendations for clinical trial participation increased from 0% in 2010 to 11% in 2011.
A statewide upper GI cancer MDT is feasible. Implementation of the MDT was followed by an increase in the number of patients reviewed and the proportion reviewed within 2 weeks of diagnosis. Greater awareness of the MDT and access to it may be required to continue to increase the proportion of cancers reviewed.
为规范南澳大利亚州上消化道（GI）癌的管理，2009年末设立了一个全州范围的视频连接多学科团队（MDT）会议。尽管癌症MDT被视为一种护理标准，但评估其影响很重要。
对2010年1月1日至2011年12月31日期间由上消化道MDT评估的患者的MDT结果和建议进行回顾性审计。确定了接受评估的新发上消化道恶性肿瘤患者的比例以及在诊断后2周内接受评估的比例。对MDT会议关于治疗意图、管理、检查和试验参与的建议进行了审计。
从2010年到2011年，MDT评估的南澳大利亚州新诊断上消化道恶性肿瘤的比例从43.2%增加到54.3%。MDT评估的食管癌病例多于胃癌病例。诊断后2周内接受评估的患者比例从20%增加到50%。2010年至2011年，接受新辅助或确定性放化疗的患者比例有所增加。所有接受评估的患者中有50%被建议进行进一步检查。临床试验参与的建议从2010年的0%增加到2011年的11%。
全州范围的上消化道癌MDT是可行的。MDT实施后，接受评估的患者数量以及在诊断后2周内接受评估的比例有所增加。可能需要提高对MDT的认识并增加其可及性，以继续提高接受评估的癌症比例。
