Table 1.
Authors, year, country | Databases and date range | Number of studies (studies quality) | Cancer types and population | Objective | Outcomes / outputs | Main results |
---|---|---|---|---|---|---|
Coory et al., 2008 [38] (Australia) | Ovid Medline, and snowball search. 1984 - July 2007. | 16 (studies quality: not assessed) | Lung cancer (both SCLC and NSCLC) | To evaluate and critically appraise the effectiveness of multidisciplinary teams to treat lung cancer and particularly to assess if the TBs, compared to traditional models of care, improves survival, and other outcomes such as practice patterns and waiting times. |
Survival. Practice patterns. Waiting times. Satisfaction with care. Visits to GPs. Quality of life. |
Weak evidence of a causal association in survival improvement. Stronger evidence of the effect of TBs on changing patient management: increase in the percentage of patients undergoing surgical resection and in the percentage of patients undergoing chemotherapy or radiotherapy with curative intent. Reduced waiting times. Improved patient satisfaction. Reduced number of visits to GPs. No-statistically significant differences in patients’ quality of life. |
Lamb et al., 2011 [30] (UK) | Embase, Medline, PsycINFO (using OvidSP), Cochrane database. 1999 - 15th May 2009 | 37 (studies quality: low to medium) | Breast, lung, gynaecology, urology, upper GI, colorectal, sarcoma, brain, head and neck cancer | To examine the literature on care management decisions in cancer TBs and assess the factors that enhance or impede effective decision-making |
Diagnosis. Care management decisions. Adherence to guidelines. Treatment. Implementation of TB decisions. Survival. |
Improvement in diagnostic accuracy. Changes in care management decisions (2–52% of cases). Improved adherence to clinical guidelines. More likelihood of patients being offered chemotherapy (7–23%). TB decisions not implemented in 1–16% of cases. Significant increase in survival for patients being offered chemotherapy (3.2–6.6 months). |
Prades et al., 2015 [31] (Spain and Belgium) | Medline database. November 2005–June 2012 |
51 (studies quality: not assessed) |
Urological, pancreatic, rectal, head and neck, melanoma, oesophageal, prostate and genitourinary, colon, lung, breast, oesophageal, osteological, skin, gynaecological, and neurological cancer and bone metastases | To assess the impact of TBs on patient outcomes in cancer care and identify their objectives, organisation and ability to engage patients in the care process. |
Diagnosis and/or treatment planning. Survival. Patient quality of life. Patient and clinician satisfaction. Waiting times. Care coordination for professionals and patients. |
Improvement in diagnosis and staging accuracy; more appropriate treatment through preoperative review of imaging and pathology results; more up-to-date treatment; structured follow-up care plan. Improved survival. Patient quality of life improvement. Improved patient and clinician satisfaction. Reduced waiting times. Coordination and continuity of care improvement by reducing time from diagnosis to treatment; achieving early and appropriate referral patterns. Furthermore: teaching environment for healthcare professionals and junior doctors; increased enrolment in tumour registry; maintaining a commitment to research and clinical trials |
Pillay et al., 2016 [32] (Australia) | OVID Medline, PsycINFO, and EMBASE databases. 1995 - April 2015 | 27 (studies quality: not assessed) |
Colon or rectal, lung, oesophageal or gastric, urological, gynaecological, breast, hematologic and head and neck tumours. Mean or median age range: 54–71 years. Sample size range: 47–6760. |
To summarise, integrate, and critically evaluate the literature regarding the impact of TBs on patient assessment, diagnosis, management and outcomes in oncology settings. |
Patient assessment/diagnosis. Patient management/clinical practice. Waiting times. Survival, recurrence rates/remaining tumour after resection and rate of metastasis. |
Changes in diagnostic reports after TB discussion (between 4 and 35% of patients discussed at TBs); more likelihood to receive more accurate and complete pre-operative staging for patients discussed at TBs. Changes in patient management/clinical practice after discussion reported in 4.5–52% of cases. More likelihood to receive neoadjuvant/adjuvant treatment and greater adherence to guidelines for patients discussed at TBs. Limited evidence for improved waiting times. Limited evidence for improved survival of patients discussed at TBs; little positive impact on local recurrence rates/remaining tumour after resection and incidence of metastases. |
Basta et al., 2017 [34] (The Netherlands) | PubMed, MEDLINE and EMBASE electronic databases. Until 30 November 2016. | 16 (studies quality: fair) | Gastrointestinal malignancies: oesophageal or gastric, colorectal, pancreatic or biliary, liver malignancy or neuroendocrine, other malignancies. | To assess whether the discussion in a multidisciplinary gastrointestinal cancer team meeting influences the diagnosis and treatment plan for patients with GI malignancies. |
Diagnosis and staging. Treatment plan and adherence to guidelines. Implementation of the treatment plan. |
Changes in the diagnoses formulated by individual physicians after TB discussion (18.4–26.9% of evaluated cases); accurate diagnosis in 89–93.5% of cases evaluated by TBs; more frequent complete staging evaluation for patients discussed. Treatment plan altered in 23.0–41.7% of evaluated cases; increased adherence to guidelines. TB decisions implemented in 90–100% of evaluated cases. |