Читать книгу Surgical Management of Advanced Pelvic Cancer - Группа авторов - Страница 25

Multidisciplinary team meetings (MDTMs) have been implemented to deal with the complexity of cancer care [1]. The aim of these meetings is to provide a structured discussion platform to plan patient care [2–7]. The goal is to benefit from the collective knowledge of all specialties in order to optimize staging, treatment, and follow‐up. Furthermore, it can facilitate assessment for patients’ inclusion in clinical trials.

The organization of the MDTM is time consuming and comes with costs. Delaying decisions until the MDTM has taken place can sometimes delay treatment. MDTM results in a significant change in diagnosis or treatment planning, ranging from 18.5 to 36% and 11.0 to 14.5% respectively [8–14].The role of adequate preoperative tumor staging and discussion in an MDTM resulted in more patients receiving neoadjuvant treatment, increased local control, and R0 resections [15].

The governing body for the quality of care for patients with cancer in the Netherlands is the Stichting voor Oncologische Samenwerking (Foundation for Oncological Collaboration, SONCOS) [16]. SONCOS represents 29 national societies involved in cancer care, including the Society for Medical Oncology, the Society of Surgical Oncology, and the Society of Radiation Oncology. SONCOS delivers a yearly report stating the conditions that must be fulfilled by any multidisciplinary team caring for cancer patients. Dutch physicians are obliged to adhere to these conditions. Furthermore, all Dutch medical centers have agreed to standardize data registry with a national database to monitor the effect of changes in treatment strategy on quality measurements as shown in Figure 2.1. Hence, factors improving the quality of care can be identified and applied easily in order to improve patient outcome. MDTMs across the Netherlands can deal with the majority of patients with pelvic cancer from gastroenterological, urological, or gynecological origin. However, patients with locally advanced and recurrent pelvic cancer should be discussed in a specialized MDTM [16].