Multidisciplinary team meeting in the core of nasopharyngeal cancer management improved quality of care and survival of patients

Abstract

Abstract Background Nasopharyngeal cancer (NPC) is a common cancer in Asia. In many developing countries, most cases are in advanced stages, compromising the outcome of treatment. The complexity of NPC management for advanced-stage NPC requires thorough communication and shared clinical decisions between medical professionals and allied teams. Incorporating a multidisciplinary team meeting (MDTM) for newly diagnosed NPC patients was chosen to facilitate clinical collaboration and communication between physicians. This recent study aimed to compare quality of care, clinical responses and survival between NPC patients treated inside and outside of MDTM care. Methods This was a retrospective study comparing NPC patients treated under the MDTM with NPC patients managed outsidethe MDTM. Clinical responses, assessment visits, date of progression and date of death were collected. Data were analyzed with X2 for discrete variables and t tests for continuous variables. Kaplan‒Meier survival curves with log-rank tests were used to describe the difference in survival estimation between the groups. Cox regression hazard models were calculated to predict the hazard risk for progression and survival. Significance was determined as p < 0.05. Results There were 87 patients treated under MDTM and 178 patients treated outside MDTM. Histology type of WHO type 3 was predominant. Stages IVA and B accounted for more than 60% of patients. Revision of diagnosis during MDTM accounted for 5.7%, and revision of stage occurred in 52.9%of cases. More clinical responses were achieved by patients treated under MDTM than by patients outside MDTM (69.0% vs. 32.0%, p < 0.00). The median progression-free survival of NPC patients under MDTM was 59.89 months compared with 12.68 months outside MDTM (log rank p < 0.00). Overall survival was longer in patients treated under MDTM compared with patients outside MDT (not reached vs. 13.44 months; p < 0.00). NPC patients who received treatment recommendations from the MDTM had a lower risk for progression (HR 0.267, 95% CI 0.17-0.40, p < 0.00) and mortality (HR 0.134; 95% CI 0.08 -0.24, p < 0.00). Conclusion Incorporating the MDTM approach into NPC management improves the clinical response and survival of patients.