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Results of a nationwide survey on multidisciplinary teams on thyroid cancer in Spain

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Abstract

Aim

There is an important lack of knowledge as to the functioning of multidisciplinary teams on thyroid cancer in current clinical practice. We aimed to retrieve data on the composition, structure, and procedures developed by the multidisciplinary units of thyroid cancer in Spain.

Methods

A nationwide survey consisting of questions about composition, structure, and functioning of multidisciplinary teams was designed. It was available online from November 15, 2017 to February 15, 2018.

Results

Seventy-two multidisciplinary units responded to our survey. Of these, 15 (20.8%) focused only in thyroid cancer, while 57 (79.2%) included other endocrine disorders or non-endocrine tumors. The median (interquartile range) of members of the teams was 11 (9–14). The most frequent medical specialties in the units were endocrinology (100%), surgery (94.4%), pathology (80.6%), radiology (75.0%), nuclear medicine (73.6%), and medical oncology (55.6%). The annual number of patients reviewed by the teams was 40 (20–74). 56.9% of the multidisciplinary teams have elaborated clinical protocols for local use. Apart from clinical case discussions in the meetings, 45.8% of the units included educational activities and 36.1% research subjects. Quality indicators were developed by 22% of the teams.

Conclusions

These results suggest that there are some hopeful signs that international recommendations of having multidisciplinary approach to patients with thyroid cancer are being followed in Spain. This gives us the opportunity to proceed with further studies to analyze the real impact of this high standard of care on patient outcomes.

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References

  1. Díez JJ, Grande E, Alonso T, Iglesias P. Abordaje multidisciplinar en el diagnóstico y tratamiento de pacientes con tumores endocrinos. Med Clín (Barc). 2015;145:36–41.

    Article  Google Scholar 

  2. Lamb BW, Taylor C, Lamb JN, Strickland SL, Vicent C, Green JSA, et al. Facilitators and barriers to teamworking and patient centeredness in multidisciplinary cancer teams: findings of a national study. Ann Surg Oncol. 2013;20:1408–16.

    Article  CAS  PubMed  Google Scholar 

  3. Taylor C, Munro AJ, Glynne-Jones R, Griffith C, Trevatt P, Richards M, et al. Multidisciplinary team working in cancer: What is the evidence? BMJ. 2010;340:c951.

    Article  PubMed  Google Scholar 

  4. Tamagno G, Sheahan K, Skehan SJ, Geoghegan JG, Fennelly D, Collins CD, et al. Initial impact of a systematic multidisciplinary approach on the management of patients with gastroenteropancreatic neuroendocrine tumor. Endocrine. 2013;44:504–9.

    Article  CAS  PubMed  Google Scholar 

  5. Pawlik TM, Laheru D, Hruban RH, Coleman J, Wolfgang CL, Campbell K, et al. Evaluating the impact of a single-day multidisciplinary clinic on the management of pancreatic cancer. Ann Surg Oncol. 2008;15:2081–8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Horvath LE, Yordan E, Malhotra D, Leyva I, Bortel K, Schalk D, et al. Multidisciplinary care in the oncology setting: historical perspective and data from lung and gynecology multidisciplinary clinics. J Oncol Pract. 2010;6:e21–6.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bible KC, Smallridge RC, Morris JC, Molina JR, Suman VJ, Copland JA, et al. Development of a multidisciplinary, multicampus subspecialty practice in endocrine cancers. J Oncol Pract. 2012;8:e1s–5s.

    Article  PubMed  PubMed Central  Google Scholar 

  8. European Partnership Action Against Cancer consensus group, Borras JM, Albreht T, Audisio R, Briers E, Casali P, et al. Policy statement on multidisciplinary cancer care. Eur J Cancer. 2014;50:475–80.

    Article  Google Scholar 

  9. Díez JJ, Galofré JC, Oleaga A, Grande E, Mitjavila M, Moreno P, et al. Declaración de consenso para la acreditación de unidades multidisciplinares en cáncer de tiroides. Endocrinol Nutr. 2016;63:e1–15.

    Article  PubMed  Google Scholar 

  10. Ghasemi A, Zahediasl S. Normality tests for statistical analysis: a guide for non-statisticians. Int J Endocrinol Metab. 2012;10:486–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Instituto Nacional de Estadística. Cifras oficiales de población resultantes de la revisión del Padrón municipal a 1 de enero. Población por comunidades y ciudades autónomas y tamaño de los municipios. Available at: https://www.ine.es/jaxiT3/Tabla.htm?t=2915&L=0. Visited on 16 Jan 2019.

  12. Ministerio de Sanidad, Consumo y Bienestar Social. Portal Estadístico. Area de Inteligencia de Gestión. Base de Datos de Clínicos de Atención Primaria (BDCAP). Problemas de Salud. Available at: http://pestadistico.inteligenciadegestion.msssi.es/publicoSNS/comun/Cubo.aspx?IdNodo=22126. Visited on 16 Jan 2019.

  13. Wright FC, De Vito C, Langer B, Hunter A. Multidisciplinary cancer conferences: a ystematic review and development of practice standards. Eur J Cancer. 2007;43:1002–10.

    Article  CAS  PubMed  Google Scholar 

  14. Perros P, Boelaert K, Colley S, Evans C, Evans RM, Gerrard BG, et al. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf). 2014;81(Suppl 1):1–122.

    Article  CAS  Google Scholar 

  15. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Díez JJ, Oleaga A, Álvarez-Escolá C, Martín T, Galofré JC. Grupo de Trabajo de Cáncer de Tiroides de la Sociedad Española de Endocrinología y Nutrición. Guía clínica para el manejo de pacientes con carcinoma diferenciado de tiroides de bajo riesgo. Endocrinol Nutr. 2015;62:e57–72.

    Article  PubMed  Google Scholar 

  17. Sarkar S, Arora S, Lamb B, Green J, Sevdalis N, Darzi A. Case review in urology multidisciplinary team meetings: what members think of its functioning. J Clin Urol. 2014;7:394–402.

    Article  Google Scholar 

  18. Lamb B, Jalil R, Sevdalis N, Vincent C, Green J. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study. BMC Health Serv Res. 2014;14:377.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sundi D, Cohen JE, Cole AP, Neuman BP, Cooper J, Faisal FA, et al. Establishment of a new prostate cancer multidisciplinary clinic: format and initial experience. Prostate. 2015;75:191–9.

    Article  PubMed  Google Scholar 

  20. Kelly SL, Jackson JE, Hickey BE, Szallasi FG, Bond CA. Multidisciplinary clinic care improves adherence to best practice in head and neck cancer. Am J Otolaryngol. 2013;34:57–60.

    Article  PubMed  Google Scholar 

  21. Korman H, Lanni T, Shah C, Parslow J, Tull J, Ghilezan M, et al. Impact of a prostate multidisciplinary clinic program on patient treatment decisions and on adherence to NCCN guidelines: the William Beaumont Hospital experience. Am J Clin Oncol. 2013;20:778–84.

    Google Scholar 

  22. Keating NL, Landrum MB, Lamont EB, Bozeman SR, Shulman LN, McNeil BJ. Tumor boards and the quality of cancer care. J Natl Cancer Inst. 2013;105:113–21.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lamb BW, Green JS, Benn J, Brown KF, Vincent CA, Sevdalis N. Improving decision making in multidisciplinary tumor boards: prospective longitudinal evaluation of a multicomponent intervention for 1,421 patients. J Am Coll Surg. 2013;217:412–20.

    Article  PubMed  Google Scholar 

  24. Henry M, Frenkiel S, Chartier G, MacDonald C, Payne RJ, Black JM, et al. Thyroid cancer patients receiving an interdisciplinary team-based approach (ITCA-ThyCa) appear to display better outcomes: program evaluation results indicating a need for further integrated care and support. Psychooncology. 2018;27:937–45.

    Article  PubMed  Google Scholar 

  25. Lamb BW, Brown KF, Nagpal K, Vincent C, Green JSA, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18:2116–25.

    Article  PubMed  Google Scholar 

  26. McCarthy M, Datta P, Khachatryan A, Coleman MP, Rachet B. Would compliance with cancer care standards improve survival for breast, colorectal and lung cancers? J Epidemiol Community Health. 2008;62:650–4.

    Article  CAS  PubMed  Google Scholar 

  27. El Saghir NS, Keating NL, Carlson RW, Khoury KE, Fallowfield L. Tumor boards: optimizing the structure and improving efficiency of multidisciplinary management of patients with cancer worldwide. Am Soc Clin Oncol Educ Book. 2014. https://doi.org/10.14694/edbook_am.2014.34.e461.

    Article  PubMed  Google Scholar 

  28. Tree AC, Harding V, Bhangu A, Krishnasamy V, Morton D, Stebbing J, et al. The need for multidisciplinarity in specialist training to optimize future patient care. Nat Rev Clin Oncol. 2017;14:508–17.

    Article  PubMed  Google Scholar 

  29. Pillay B, Wootten AC, Crowe H, Corcoran N, Tran B, Bowden P, et al. The impact of multidisciplinary team meetings on patients assessment, management and outcomes in oncology settings: a systematic review of the literature. Cancer Treat Rev. 2016;42:56–72.

    Article  PubMed  Google Scholar 

  30. Informe 2017. Registro RECALSEEN. La atención al paciente en las unidades de Endocrinología y Nutrición en el Sistema Nacional de Salud. Sociedad Española de Endocrinología y Nutrición. Available at: http://www.seen.es/actualidad/Noticias.aspx?tbBuscar=d7tNqSpfK1w9ErpVIhDH3gYRYzE9%2B2OKS379J1sxTUzVioEQVRLMBiiFK8KR5rtz. Visited on 16 Jan 2019.

  31. Chinai N, Bintcliffe F, Armstrong EM, Teape J, Jones BM, Hosie KB. Does every patient need to be discussed at a multidisciplinary team meeting? Clin Radiol. 2013;68:780–4.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Sociedad Española de Endocrinología y Nutrición (SEEN) and Sociedad Española de Medicina Nuclear e Imagen Molecular (SEMNIM) for allowing us to host our survey on their respective websites. We thank Sanofi Genzyme for the help in disseminating the survey throughout Spanish hospitals involved in the treatment of thyroid cancer patients.

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Author notes

  1. J. J. Díez

    Present address: Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla, 1, 28222, Majadahonda, Madrid, Spain

Authors and Affiliations

  1. Department of Endocrinology, Hospital Universitario Ramón y Cajal, Madrid, Spain

    J. J. Díez

  2. Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Spain

    J. C. Galofré

  3. Department of Endocrinology, Hospital Universitario Basurto, Bilbao, Spain

    A. Oleaga

  4. Department of Medical Oncology, MD Anderson Cancer Center, Madrid, Spain

    E. Grande

  5. Department of Nuclear Medicine, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain

    M. Mitjavila

  6. Department of General Surgery, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    P. Moreno

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  1. J. J. Díez
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  2. J. C. Galofré
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  3. A. Oleaga
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  4. E. Grande
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Corresponding author

Correspondence to J. J. Díez.

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Conflict of interest

The authors declare that they have no conflict of interest that could have direct or potential influence or impart bias on this work.

Ethical approval

This article does not involve the delivery of interventions on human participants or animals. This study has used only information from the specialists who kindly responded to the survey designed by the authors.

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Informed consent was not necessary, since no patient data was used in this study.

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Díez, J.J., Galofré, J.C., Oleaga, A. et al. Results of a nationwide survey on multidisciplinary teams on thyroid cancer in Spain. Clin Transl Oncol 21, 1319–1326 (2019). https://doi.org/10.1007/s12094-019-02056-4

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