S Strong 1,2, NS Blencowe1,2,T Fox1, C Reid3 , T Crosby4, H.Ford5, J M Blazeby1,2

1School of Social and Community Medicine, Canynge Hall, University of Bristol, Bristol UK.

2Division of Surgery, Head & Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

3Division of Specialised Services, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

4Velindre NHS Trust, Unit 2 Charnwood Court, Nantgarw, Cardiff

5Addenbrooke’s Department of Oncology & Cambridge Cancer Trials Centre, Cambridge

The role of multi-disciplinary teams in decision making for patients with recurrent malignant disease

MDT meetings

• Picture of mdt team

UGI cancer survival

1. Allum et al. Journal of Clinical Oncology. 2009

Aims1. investigate role MDT in decision-making

for patients with disease recurrence

2. Consider how issues addressed nationally

Methods• Sequential MDT records screened

• Patients with possible recurrence identified

• Notes reviewed and info recorded about:symptomsreason for referral & sourcetreatment decision & implementation

Results Patients discussedn=304

Suspected recurrence

n=34

Confirmed recurrence

n=29

Localn=19

Metsn=9

• 54 MDT meetings,

• 1181 discussions about 304 pts

• Recurrence confirmed in 29 pts

Results, n=29• Mostly surgical referrals (n=25)

• Symptoms

pain (n=8),

dysphagia (n=7),

weight loss (n=7)

Results, n=29

• MDT treatment decisions,

best supportive care (n=10),

chemo (n=9),

stent (n=5),

radio (n=3),

surgery (n=2)

• 19 (65.5%) reviewed by oncologist after MDT

Results, n=29

• 25 (86.2%) recommendations implemented

• Reasons for non-implementation were;

declining health (n=2)

patient preference (n=2)

Summary

• 29 patients (9%) of new MDT patients

recurrence discussed

• Majority 19 (66%) were offered further

treatments and all received CNS support

• Pts with recurrence benefit from MDT

Implications

• Should discussion of pts with recurrence at

MDT be mandatory?

• Uncertain which type of MDT is optimal