The Impact of a Multidisciplinary Team Conference on Non-Small Cell Lung Cancer Care: Time Barriers and Long-Term Outcomes

Author:

Saeteng Somcharoen12,Chewaskulyong Busyamas3ORCID,Charoentum Chaiyut3ORCID,Lertprasertsuke Nirush4,Euathrongchit Juntima5,Tajarernmuang Pattraporn3ORCID,Klunklin Pitchayaponne5,Siwachat Sophon12,Kongkarnka Sarawut4,Wannasopha Yutthaphan5ORCID,Suksombooncharoen Thatthan3ORCID,Ketpueak Thanika3,Tantraworasin Apichat126ORCID

Affiliation:

1. Clinical Surgical Research Center, Chiang Mai University, Chiang Mai 50200, Thailand

2. Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

3. Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

4. Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

5. Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

6. Clinical Epidemiology and Clinical Statistics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand

Abstract

Background/Objectives: The prolonged time to reach investigation and management decisions in non-small cell lung cancer (NSCLC) patients can negatively impact long-term outcomes. This retrospective cohort study aims to assess the impact of a multidisciplinary team conference (MDT) on NSCLC care quality and outcomes. Methods: This retrospective study included resectable NSCLC patients who underwent pulmonary resection at Chiang Mai University Hospital, Thailand, from 1 January 2009 to 31 December 2021. Patients were divided into two groups: non-MDT and MDT groups, based on the initiation of MDT on 1 March 2018. The study compared overall survival, disease-free survival, and waiting times for investigation and surgery between the two groups. The effect of MDT on these outcomes was analyzed using multivariable analysis with inverse-probability weighting propensity scores. Results: The study included 859 patients, with 583 in the non-MDT group and 276 in the MDT group. MDT groups had a higher proportion of stage I and II NSCLC patients undergoing pulmonary resection (78.6% vs. 59.69%, p < 0.001). In multivariable analysis, patients in the MDT group had a significantly higher likelihood of longer survival compared to the non-MDT group (adjusted HR 0.23, 95% CI 0.09–0.55). Median waiting times for bronchoscopy (3 days vs. 12 days, p = 0.012), pathologic report (7 days vs. 13 days, p < 0.001), and surgery scheduling (18 days vs. 25 days, p = 0.001) were significantly shorter in the MDT group. Conclusions: An MDT has a survival benefit in NSCLC care and improves waiting times for investigation and treatment steps. Further studies are needed to validate these results.

Publisher

MDPI AG

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