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. 2024 Sep 5;13(17):5276.
doi: 10.3390/jcm13175276.

The Impact of a Multidisciplinary Team Conference on Non-Small Cell Lung Cancer Care: Time Barriers and Long-Term Outcomes

Somcharoen Saeteng  1   2 , Busyamas Chewaskulyong  3 , Chaiyut Charoentum  3 , Nirush Lertprasertsuke  4 , Juntima Euathrongchit  5 , Pattraporn Tajarernmuang  3 , Pitchayaponne Klunklin  5 , Sophon Siwachat  1   2 , Sarawut Kongkarnka  4 , Yutthaphan Wannasopha  5 , Thatthan Suksombooncharoen  3 , Thanika Ketpueak  3 , Apichat Tantraworasin  1   2   6
Affiliations

The Impact of a Multidisciplinary Team Conference on Non-Small Cell Lung Cancer Care: Time Barriers and Long-Term Outcomes

Somcharoen Saeteng et al. J Clin Med. .

Abstract

Background/Objectives: The prolonged time to reach investigation and management decisions in non-small cell lung cancer (NSCLC) patients can negatively impact long-term outcomes. This retrospective cohort study aims to assess the impact of a multidisciplinary team conference (MDT) on NSCLC care quality and outcomes. Methods: This retrospective study included resectable NSCLC patients who underwent pulmonary resection at Chiang Mai University Hospital, Thailand, from 1 January 2009 to 31 December 2021. Patients were divided into two groups: non-MDT and MDT groups, based on the initiation of MDT on 1 March 2018. The study compared overall survival, disease-free survival, and waiting times for investigation and surgery between the two groups. The effect of MDT on these outcomes was analyzed using multivariable analysis with inverse-probability weighting propensity scores. Results: The study included 859 patients, with 583 in the non-MDT group and 276 in the MDT group. MDT groups had a higher proportion of stage I and II NSCLC patients undergoing pulmonary resection (78.6% vs. 59.69%, p < 0.001). In multivariable analysis, patients in the MDT group had a significantly higher likelihood of longer survival compared to the non-MDT group (adjusted HR 0.23, 95% CI 0.09-0.55). Median waiting times for bronchoscopy (3 days vs. 12 days, p = 0.012), pathologic report (7 days vs. 13 days, p < 0.001), and surgery scheduling (18 days vs. 25 days, p = 0.001) were significantly shorter in the MDT group. Conclusions: An MDT has a survival benefit in NSCLC care and improves waiting times for investigation and treatment steps. Further studies are needed to validate these results.

Keywords: MDT; NSCLC; inverse-probability weighting propensity score; lung cancer care; time barrier; waiting time.

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Conflict of interest statement

Some results of this study were presented at the IASC 2022 Asia Conference on Lung Cancer (ACLC) on 27–29 October 2022, Nara, Japan, as a poster presentation. The poster’s abstract was published in ‘Abstract book’ available at https://aclc2022.iaslc.org/wp-content/uploads/2022/10/ACLC2022-Abstract-Book.pdf (accessed on 8 August 2024). The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
A demonstration of the framework for the multidisciplinary team approach in patients presenting with lung mass, lung nodule, or lung cancer. (Abbreviations: OPD—Out-Patient Clinic, CT—Computed Tomography, PET/CT—Positron Emission Tomography/Computed Tomography, EBUS—Endobronchial Ultrasound, L-EBUS—Linear Probe EBUS, FNA—Fine Needle Aspiration, Onco Med—Oncology Medicine, Chemo—systemic treatments including chemotherapy, immunotherapy, and targeted therapy, RT—radiotherapy, ESMO—European Society for Medical Oncology, NCCN—National Comprehensive Cancer Network, CA—cancer, MED—medicine).
Figure 2
Figure 2
Demonstration of time framework of treatment for lung cancer after MDT conference. (Abbreviations: MDT—multidisciplinary team, gen med—general medicine, chest med—chest medicine (pulmonology medicine), CT—Computed Tomography, PET/CT—Positron Emission Tomography/Computed Tomography, tissue patho—tissue pathology, chest surg—chest surgery (thoracic surgery), chemo—chemotherapy.
Figure 3
Figure 3
The proportion of patients in each stage of disease between the two groups (before MDT and after MDT initiation). (Abbreviations: MDT—multidisciplinary team).
Figure 4
Figure 4
Adjusted survival curve between the two groups.
Figure 5
Figure 5
Box plot of the waiting time for bronchoscope (day), the waiting time for pathologic or cytologic results (day), and the schedule time for surgery (day) between the two groups, analyzed by Wilcoxon rank sum test. (Abbreviations: MDT—multidisciplinary team, FOB—fiberoptic bronchoscopy, pathologic result—the waiting time for pathologic or cytologic report, surgery—the waiting time for surgery).
See this image and copyright information in PMC

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