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Review
. 2023 Sep 22;4(12):100580.
doi: 10.1016/j.jtocrr.2023.100580. eCollection 2023 Dec.

Does Multidisciplinary Team Management Improve Clinical Outcomes in NSCLC? A Systematic Review With Meta-Analysis

Gilberto de Castro Jr  1 , Fabiano Hahn Souza  2 , Júlia Lima  2 , Luis Pedro Bernardi  2 , Carlos Henrique Andrade Teixeira  3 , Gustavo Faibischew Prado  3 ; Grupo Brasileiro de Oncologia Torácica (GBOT)
Affiliations
Review

Does Multidisciplinary Team Management Improve Clinical Outcomes in NSCLC? A Systematic Review With Meta-Analysis

Gilberto de Castro Jr et al. JTO Clin Res Rep. .

Abstract

Introduction: The implementation of multidisciplinary teams (MDTs) has been found to be effective for improving outcomes in oncology. Nevertheless, there is still a dearth of robust literature on patients with NSCLC. The aim of this study was to conduct a systematic review regarding the impact of MDTs on patient with NSCLC outcomes.

Methods: Databases were systematically searched up to February 2023. Two reviewers independently performed study selection and data extraction. Risk of bias was evaluated using the Newcastle-Ottawa and certainty of evidence by the Grading of Recommendations Assessment, Development and Evaluation approach. Overall survival was the primary outcome. Secondary outcomes included mortality, length of survival, progression-free survival, time from diagnosis to treatment, complete staging, treatment received, and adherence to guidelines. A meta-analysis with a random-effect model was performed. Statistical analysis was performed with the R 3.6.2 package.

Results: A total of 22 studies were included in the systematic review. Ten outcomes were identified, favoring the MDT group over the non-MDT group. Pooled analysis revealed that patients managed by MDTs had better overall survival (three studies; 38,037 participants; hazard ratio 0.60, 95% confidence interval [CI]: 0.49-0.75, I2 = 78%), shorter treatment time compared with patients in the non-MDT group (six studies; 15,235 participants; mean difference = 12.20 d, 95% CI: 10.76-13.63, I2 = 63%), and higher proportion of complete staging (four studies; 14,925 participants; risk ratio = 1.36, 95% CI: 1.17-1.57, I2 = 89%).

Conclusions: This meta-analysis revealed that MDT-based patient care was associated with longer overall survival and better quality-of-care-related outcomes.

Keywords: Lung cancer; Multidisciplinary team; Outcomes; Overall survival; Prognosis.

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Figures

Figure 1
Figure 1
Flow chart of study search and selection.
Figure 2
Figure 2
Summarized results of outcomes evaluated in primary studies.
Figure 3
Figure 3
Forest plot of impact of MDT on overall survival. CI, confidence interval; HR, hazard ratio; MDT, multidisciplinary team; seTE, standard error of treatment estimate; TE, estimate of treatment effect.
Figure 4
Figure 4
Forest plot of pooled mean difference of time from diagnosis to first treatment in non-MDT group compared with MDT group. CI, confidence interval; MD, mean difference; MDT, multidisciplinary team.
Figure 5
Figure 5
Forest plot of pooled risk ratio of complete staging in MDT group compared with non-MDT group. CI, confidence interval; MDT, multidisciplinary team; RR, risk ratio.
See this image and copyright information in PMC

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