Evaluation of multidisciplinary team decisions in neuroendocrine neoplasms: Impact of expert centres

Wouter T. Zandee, Elettra Merola*, Karolina Poczkaj, Louis de Mestier, Heinz Josef Klümpen, Karen Geboes, Wouter W. de Herder, Alia Munir

*Corresponding author for this work

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Abstract

Objective: To evaluate the impact of multidisciplinary team (MDT) meetings on the management of patients with neuroendocrine neoplasms (NENs). Methods: All newly referred gastro-entero-pancreatic (GEP)-NEN patients discussed from 1 April to 1 October 2017 in the MDT of seven European expert centres were prospectively included. The impact on patients' management was defined as a change in diagnosis, grade, stage or treatment. Results: A total of 292 patients were included, mainly small intestinal (siNENs) (32%) and pancreatic NENs (28%), with distant metastases in 51%. Patients had received prior surgery in 43% of cases and prior medical treatment in 32%. A significant change occurred in 61% of NENs: 7% changes in diagnosis, 8% in grade and 16% in stage. The MDT recommended a new treatment for 51% of patients, mainly surgery (9%) or somatostatin analogues (20%). A significant change was most frequently observed in patients with Stage IV disease (hazard ratio [HR] 3.6, 95% confidence interval [CI]: 1.9–6.9 vs. Stage I) and G2 NENs (vs. G1, HR 2.1 95% CI: 1.2–3.8). Conclusion: NEN-dedicated MDT discussion in expert centres yields significant management changes in over 60% of patients and thus represents the gold standard for the management of these patients.

Original languageEnglish
Article numbere13639
JournalEuropean Journal of Cancer Care
Volume31
Issue number6
Early online date23 Jun 2022
DOIs
Publication statusPublished - Nov 2022

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© 2022 John Wiley & Sons Ltd.

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