There is little information on the impact of the colorectal multi-disciplinary team in the United Kingdom.
Dr Ewan MacDermid and colleagues from the United Kingdom assessed the effect of this on patients' survival, and trends in the use of adjuvant chemotherapy.
The team's single operator presented patients before and after the inception of a multi-disciplinary team meeting in 2002.
Data were collected on 310 patients undergoing colectomy for colorectal cancer by one surgeon.
Excluding patients with Dukes A stage, the pre-multi-disciplinary team cohort from 1997 to 2002 was 176, and the post-multi-disciplinary team cohort from 2002 to 2005 was 134.
The research team calculated 3-year survival rates using Kaplan–Meier life table analysis.
Prognostic factors were analysed using Cox-proportional hazard regression, and chemotherapy data analysed using the chi-squared test.
Independent prognostic indicators of chemotherapy prescription were examined using binary logistic testing.
Results multi-disciplinary team status was shown to be an independent predictor of survival on hazard regression analysis.
A significantly greater number of patients were prescribed adjuvant chemotherapy in the post-multi-disciplinary team cohort.
Multi-disciplinary team status was shown to be a significant prognostic indicator of chemotherapy prescription.
The researchers observed that the 3-year survival for Dukes C patients was 58% in the pre-multi-disciplinary team group, and 66% in the post-multi-disciplinary team group.
Dr MacDermid’s team concludes, “There was a significant increase in patients undergoing adjuvant postoperative chemotherapy after the inception of the multi-disciplinary team.”
“This was associated with a significant survival benefit in patients with Dukes C disease.”
“The data suggest that the multi-disciplinary team process has resulted in an increase in the prescription of adjuvant chemotherapy, with 3-year survival being greater after its inception.”