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Review
. 2015 May;13(5):827-35.
doi: 10.1016/j.cgh.2014.03.038. Epub 2014 Jun 5.

Building the multidisciplinary team for management of patients with hepatocellular carcinoma

Willscott E Naugler  1 , Angel E Alsina  2 , Catherine T Frenette  3 , Lorenzo Rossaro  4 , Marty T Sellers  5
Affiliations
Review

Building the multidisciplinary team for management of patients with hepatocellular carcinoma

Willscott E Naugler et al. Clin Gastroenterol Hepatol. 2015 May.

Abstract

Optimal care of the patient with hepatocellular carcinoma (HCC) necessitates the involvement of multiple providers. Because the patient with HCC often carries 2 conditions with competing mortality risks (cancer and underlying cirrhosis), no single provider is equipped to deal with all of these patients' needs adequately. Multidisciplinary teams (MDTs) have evolved to facilitate care coordination, reassessments of clinical course, and nimble changes in treatment plans required for this complex group of patients. Providers or sites that elect to manage patients with HCC thus are increasingly aware of the need to build their own MDT or communicate with an established one. The availability of new communication technologies, such as teleconferencing or teleconsultation, offers the possibility of MDT expansion into underserved or rural areas, as well as areas such as correctional facilities. Although the availability of resources for HCC patient care varies from site to site, construction of an MDT is possible in a wide spectrum of clinical practices, and this article suggests a blueprint for assembly of such collaboration. Research strategies are needed to explain how MDTs improve clinical outcomes so that MDTs themselves can be improved.

Keywords: HCC; Hepatocellular Carcinoma; Liver Cancer; Multidisciplinary Team.

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Conflict of interest statement

Conflicts of interest

These authors disclose the following: Angel Alsina has served on the speakers bureau for Bayer, Onyx, and Novartis Pharmaceuticals; Catherine Frenette has served on the speakers bureau for Bayer and Onyx Pharmaceuticals; and Lorenzo Rossaro and Marty Sellers have served on the speakers bureau and advisory boards for Bayer and Onyx Pharmaceuticals. The remaining author discloses no conflicts.

Figures

Figure 1
Figure 1
BCLC staging system for HCC. M1, metastatic disease; N1, node positive; PS, performance score; RFA, radiofrequency ablation; TACE, transarterial chemoembolization. Reproduced with permission of John Wiley & Sons, Inc. Hepatology 2011;53:1020–1022.
Figure 2
Figure 2
Example of one Liver MDT group (Oregon Health and Science University [OHSU]); case number over 3 years.
See this image and copyright information in PMC

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