Abstract

Multidisciplinary team working in cancer: what is the evidence?
BMJ2010; 340 doi: http://dx.doi.org/10.1136/bmj.c951(Published 23 March 2010) Cite this as: BMJ 2010;340:c951



Clinical decision making

A multidisciplinary approach to clinical decision making aims to ensure that tumours are accurately staged and treatment recommendations are evidence based, patient centred, and reached by consensus. Two observational studies in breast cancer found that multidisciplinary teams resulted in more evidence based recommendations and more timely treatment.18 19

The treatment recommendations made by multidisciplinary teams do not always take into account the patients’ preferences and their wider psychological and social issues. Analysis of decision making within upper gastrointestinal and colorectal cancer teams in the UK showed that 10-15% of treatment recommendations were not implemented.20 21 Typically, patients received more conservative treatment than originally planned because the teams had not considered patient based information such as comorbidity and patient preferences.


Clinical outcomes

In the UK, multidisciplinary working is associated with improved five year survival in colorectal22 and oesophageal cancer23 and improved two year survival in head and neck cancer.24 A recent systematic review also reports limited evidence of improved survival in lung cancer.25 In Sweden, introduction of multidisciplinary care was associated with improved seven year relative survival from breast cancer.26 Differences in survival rates within one healthcare region were eliminated once they established multidisciplinary teams and adhered to regional treatment guidelines.


25. Coory M, Gkolia P, Yang I, Bowman R, Fong K. Systematic review of multidisciplinary teams in the management of lung cancer. Lung Cancer2008;60:14-21
















Cath Taylor, research fellow1,
Alastair J Munro, professor of radiation oncology2,
Rob Glynne-Jones, consultant clinical oncologist3,
Clive Griffith, consultant breast surgeon4,
Paul Trevatt, Macmillan network nurse director5,
Michael Richards, national cancer director6,
Amanda J Ramirez, professor of liaison psychiatry7

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