Is referral to the neuro-oncology MDT safe?

Abstract

Introduction: Since 2006, National Institute for Health and Clinical Excellence (NICE) guidelines advise referral of any suspected brain tumour to a dedicated neuro-oncology multidisciplinary team (MDT). We investigated two aspects of MDT safety: whether time to operation was delayed and whether brain abscesses were inappropriately referred to the MDT. MATERIAL(S) AND METHODS: We reviewed the notes of 220 consecutive patients referred to our neuro-oncology service before and after implementation of a pre-operative MDT meeting.

Results: Median time to operation was similar for patients referred before and after introduction of the MDT (8 days pre-MDT, 9 days post-MDT). There were four abscesses referred via the MDT with a significantly longer median time to operation than in the pre-MDT era (6 days vs. 1 day), although no patient came to any apparent harm as a consequence. No lesion imaged with MRI was misdiagnosed.

Discussion: Pre-operative MDT does not lengthen time to operation for patients with brain tumour. However, it may delay time to operation for abscesses inadvertently referred via the MDT route. We advocate the use of MRI to minimise the risk of misdiagnosis of cerebral abscesses.