Setup of multidisciplinary team discussions for patients with cholangiocarcinoma: current practice and recommendations from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

M. Casadio*, V. Cardinale, H. J. Klümpen, H. Morement, A. Lacasta, B. G. Koerkamp, J. Banales, D. Alvaro, J. W. Valle, A. Lamarca

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

12 Citations (Scopus)
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Abstract

Background: Cholangiocarcinomas (CCAs) are a rare group of malignancies characterized by dismal prognosis. There are currently no standardized guidelines for multidisciplinary teams (MDTs) in CCAs. Material and methods: An online survey was built with the aim of defining the current practice of MDTs in CCAs and identifying possible areas of improvement, providing minimum standards of practice for an ideal CCA MDT. Analysis of the replies regarding current and ideal MDT practice was carried out by calculating weighted average (WA) of likelihood of every item. The survey was shared with members of the European Network for the Study of Cholangiocarcinoma and other medical centers with expertise in biliary tract cancer part of the EURO-CHOLANGIO-NET (European Cholangiocarcinoma Network: https://eurocholangionet.eu/) COST Action CA18122 initiative. Results: The role of the MDT coordinator was a recognized priority in an ideal well-functioning MDT (WA 3.31/4), together with providing minimum clinical information before the meeting to secure adequate case preparation (WA 3.54/4). Optimal frequency of MDT meetings was weekly according to 76.92% of the participants; 73.06% believed that ideally all newly diagnosed patients and each new treatment should be discussed, although that happened only in less than half of the MDTs (46.15%) in current practice. Most participants stated that they always (46.15%) or often (50.00%) used guidelines, mainly international (61.00%) (European and American), followed by national/local (39.00%). We defined the ideal setup of a CCA MDT, identifying specialists whose presence is mandatory with WA >3.0 (oncologist, clinician responsible for patient's care, surgeon, diagnostic and interventional radiologist, hepatologist, pathologist, endoscopist and gastroenterologist) and those whose presence would be recommended with a WA <3.0 (palliative care, nurse, dietitian, basic researcher, psychologist and social worker). Conclusions: Our identified minimum requirements should be taken into account at the time of CCA MDT setup and quality assessment.

Original languageEnglish
Article number100377
JournalESMO Open
Volume7
Issue number1
Early online date27 Jan 2022
DOIs
Publication statusPublished - 1 Feb 2022

Bibliographical note

Funding Information:
AL declares travel and educational support from Ipsen, Pfizer, Bayer, AAA, SirtEx, Novartis, Mylan and Delcath; speaker honoraria from Merck, Pfizer, Ipsen, Incyte, AAA and QED; advisory honoraria from EISAI, Nutricia Ipsen, QED and Roche; and she is a member of the Knowledge Network and NETConnect Initiatives funded by Ipsen, all outside the scope of this work. JWV reports personal fees from Agios, AstraZeneca, Baxter, Genoscience Pharma, Hutchison Medipharma, Imaging Equipment Ltd (AAA), Incyte, Ipsen, Mundipharma EDO, Mylan, QED, Servier, Sirtex and Zymeworks; and grants, personal fees and non-financial support from NuCana, outside the submitted work. JMB declares research grants from Incyte; personal fees for lecturer from Bayer and Intercept; and consulting role for QED Therapeutics, Albireo Pharma and OWL Metabolomics. The remaining authors have declared no conflicts of interest.

Funding Information:
MC participated as mentee to the Euro-Cholangio-Net Mentorship Program of EURO-CHOLANGIO-NET COST Action CA18122, as a medical resident of gastroenterology in Sapienza University of Rome. AL received funding from The Christie Charity and the European Union’s Horizon 2020 Research and Innovation Programme [grant number 825510, ESCALON]; this article/publication is based upon work from COST Action European Cholangiocarcinoma Network, supported by COST (European Cooperation in Science and Technology; www.cost.eu), a funding agency for research and innovation networks. JB was funded by Spanish Carlos III Health Institute (ISCIII) [Miguel Servet Program grant numbers CON14/00129 and CPII19/00008]; CIBERehd (ISCIII); Department of Health of the Basque Country [grant number 2017111010]; BIOEF (Basque Foundation for Innovation and Health Research: EiTB Maratoia BIO15/CA/016/BD); ‘Fundación Científica de la Asociación Española Contra el Cáncer’ (AECC Scientific Foundation); and the European Union’s Horizon 2020 Research and Innovation Program [grant number 825510, ESCALON].

Funding Information:
MC participated as mentee to the Euro-Cholangio-Net Mentorship Program of EURO-CHOLANGIO-NET COST Action CA18122, as a medical resident of gastroenterology in Sapienza University of Rome. AL received funding from The Christie Charity and the European Union's Horizon 2020 Research and Innovation Programme [grant number 825510, ESCALON]; this article/publication is based upon work from COST Action European Cholangiocarcinoma Network, supported by COST (European Cooperation in Science and Technology; www.cost.eu), a funding agency for research and innovation networks. JB was funded by Spanish Carlos III Health Institute (ISCIII) [Miguel Servet Program grant numbers CON14/00129 and CPII19/00008]; CIBERehd (ISCIII); Department of Health of the Basque Country [grant number 2017111010]; BIOEF (Basque Foundation for Innovation and Health Research: EiTB Maratoia BIO15/CA/016/BD); ?Fundaci?n Cient?fica de la Asociaci?n Espa?ola Contra el C?ncer? (AECC Scientific Foundation); and the European Union's Horizon 2020 Research and Innovation Program [grant number 825510, ESCALON]. This research was funded by EURO-CHOLANGIO-NET (European Cholangiocarcinoma Network: https://eurocholangionet.eu/) COST Action (CA18122). AL declares travel and educational support from Ipsen, Pfizer, Bayer, AAA, SirtEx, Novartis, Mylan and Delcath; speaker honoraria from Merck, Pfizer, Ipsen, Incyte, AAA and QED; advisory honoraria from EISAI, Nutricia Ipsen, QED and Roche; and she is a member of the Knowledge Network and NETConnect Initiatives funded by Ipsen, all outside the scope of this work. JWV reports personal fees from Agios, AstraZeneca, Baxter, Genoscience Pharma, Hutchison Medipharma, Imaging Equipment Ltd (AAA), Incyte, Ipsen, Mundipharma EDO, Mylan, QED, Servier, Sirtex and Zymeworks; and grants, personal fees and non-financial support from NuCana, outside the submitted work. JMB declares research grants from Incyte; personal fees for lecturer from Bayer and Intercept; and consulting role for QED Therapeutics, Albireo Pharma and OWL Metabolomics. The remaining authors have declared no conflicts of interest.

Funding Information:
This research was funded by EURO-CHOLANGIO-NET (European Cholangiocarcinoma Network: https://eurocholangionet.eu/ ) COST Action ( CA18122 ).

Publisher Copyright:
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