To investigate decision making for patients with advanced ovarian cancer as a possible explanation of geographical variation in treatment patterns.
We carried out a multi-centre observational study in multidisciplinary teams meetings for five major UK cancer centres. All patients presenting to five cancer centres with advanced ovarian cancer over a six-week period. The GO-MDT-MODe tool was used to provide a measure of participation and quality of case discussion for all cases of advanced ovarian cancer. MDT scores were correlated with surgical data extracted from national audit data. Data were recorded for overall MDT performance.
A total of 870 case discussions, including 145 cases of advanced ovarian cancer, were observed. MDTs varied in structure, format and time allocation between centres. Cluster analysis showed significant variation in quality and participation of discussion between centres (p < 0.0025) and this correlated with the proportion of patients in the wider cancer alliance undergoing surgery.
We have shown that at least part of the variation in practice seen in the UK correlates with different behaviours within MDTs. Increasing time for discussion and encouraging participation from all staff groups may increase proportions of patients undergoing optimal treatment regimens.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Surgical Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Epithelial ovarian cancer.Lancet. 2019; 393: 1240-1253
- Improved survival from ovarian cancer in patients treated in phase III trial active cancer centres in the UK.Clin Oncol. 2016; 28: 760-765
- NCRAS. Ovarian cancer audit feasibility pilot. 2020
- Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer.Cochrane Database Syst Rev. 2019; 2019
- The anatomy of clinical decision-making in multidisciplinary cancer meetings: a cross-sectional observational study of teams in a natural context.Medicine (Baltim). 2016; 95e3885
- Multidisciplinary team decision-making in cancer and the absent patient: a qualitative study.BMJ Open. 2016; 6e012559
- Decision making in gynaecological oncology multidisciplinary team meetings: a cross sectional, observational study of ovarian cancer cases.Oncol. Res. Treat. 2020; 43: 70-76
- Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an observational assessment tool.BMJ Qual Saf. 2011; 20: 849-856
- Tumor boards and the quality of cancer care.J Natl Cancer Inst. 2013; 105: 113-121
- Medical and nonmedical information during multidisciplinary team meetings in cancer care.Curr Oncol. 2021; 28: 1008-1016
- A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology.Br J Cancer. 2013; 109: 2295-2300
Published online: March 15, 2023
Accepted: March 11, 2023
Received in revised form: February 27, 2023
Received: December 12, 2022
Publication stageIn Press Journal Pre-Proof
© 2023 Published by Elsevier Ltd.