The effect of multidisciplinary teams for rectal cancer on delivery of care and patient outcome: has the use of multidisciplinary teams for rectal cancer affected the utilization of available resources, proportion of patients meeting the standard of care, and does this translate into changes in patient outcome?

• Published in: The American journal of surgery Vol. 211; no. 1; pp. 46 - 52
• Main Authors: Richardson, Bradford, M.D., M.P.H, Preskitt, John, M.D, Lichliter, Warren, M.D, Peschka, Stephanie, R.N, Carmack, Susanne, M.D, de Prisco, Gregory, M.D, Fleshman, James, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2016; Elsevier Limited
• Subjects: Adult; Aged; Cancer therapies; Chemotherapy; Circumferential resection margin; Colorectal cancer; Female; Follow-Up Studies; Genetic counseling; Health Resources - utilization; Humans; Male; Medical imaging; Middle Aged; Multi-disciplinary teams; NMR; Nuclear magnetic resonance; Nuclear medicine; Oncology; Outcome and Process Assessment (Health Care); Pathology; Patient Care Team - organization & administration; Patients; Quality standards; Rectal cancer; Rectal Neoplasms - surgery; Rectum - surgery; Retrospective Studies; Standard of Care; Surgery; Texas; Total mesorectal excision; Texas; Multi-disciplinary teams; Total mesorectal excision; Rectal cancer; Circumferential resection margin
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2015.08.015

Abstract Background We hypothesized that mandatory multidisciplinary team (MDT) participation improves process evaluation, outcomes, and technical aspects of surgery for rectal cancer in a stable practice of colorectal surgery. Methods A retrospective review of MDT data was conducted of all patients with colorectal cancer since 2010. Demographic, clinical stage, process evaluation, quality of surgery, and outcome data were collected. Total mesorectal excision and MDT required participation started 2013. Results One hundred thirty patients were included in this study: 47 patients in 2014; 41 patients in 2013; and 42 patients pre-MDT. Improvements were seen in 12 of the 14 preoperative process variables, 6 significantly. Improvement in the completeness of total mesorectal excision (0% to 76%) was significant. Local recurrence occurred in 10% of the pre-MDT group, and follow-up is ongoing in the MDT groups. Conclusions MDT participation improves care of patients with rectal cancer. Preoperative clinical staging, multimodality treatment, pathologic staging, and technical aspects of surgery have improved.