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Expectations of Discipline Representation on Multidisciplinary Treatment Planning (MTP) Teams.

Journal of clinical oncology(2013)

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摘要
195 Background: The Commission on Cancer’s (CoC) standards require accredited cancer programs to utilize a multidisciplinary team approach for treatment planning. A recent CoC survey sought to characterize current multidisciplinary treatment planning (MTP) practice from the cancer programs’ perspective. Methods: The survey, administered to 1,261 programs, included items on team structure and process, case presentation, clinical trials and patient involvement. Each facility was designated to report on MTP for one cancer type: Breast, Gastrointestinal (GI), Lung, Head/Neck, Gynecologic (Gyn), Brain/Central Nervous System (CNS). A total of 797 (63%) facilities responded. Initial analyses highlight the disciplines expected to attend MTP meetings. Results: Forty-eight percent expected all core physician specialties (Medical Oncology, Radiation Oncology, Surgery and/or Surgical Oncology), to attend the initial case presentation. Respondents also expected affiliated specialists and professionals to attend initial case presentations, and included pathologists (90%), clinical trials nurses (46%), patient navigators (37%), primary care providers (20%), and genetic counselors (18%). Data analysis demonstrated significant variation in expected disciplinary attendance for select providers depending on type of cancer program, as illustrated below (Table). Analysis by cancer type showed that primary care physicians were expected to attend Lung MTP meetings at 25% of the facilities compared to Breast (15%). Genetic counselors were expected to attend MTP meetings for Breast (29%), Gyn (24%), and GI (18%). Additional analyses are ongoing. Conclusions: To improve cancer care quality, the CoC has put forward standards to foster multidisciplinary professional participation in the treatment of cancer care. Findings indicate expectations of attendance for key disciplines at MTP meetings vary by tumor–specific MTP and by type of cancer program. Key genetic markers for certain sites may also explain why genetic counselors are expected to attend. [Table: see text]
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