TY - JOUR
T1 - The influence of multidisciplinary team meetings on treatment decisions in advanced bladder cancer
AU - Walraven, Janneke E.W.
AU - Ripping, Theodora M.
AU - BlaZIB Study Group
AU - Oddens, Jorg R.
AU - van Rhijn, Bas W.G.
AU - Goossens-Laan, Catharina A.
AU - Hulshof, Maarten C.C.M.
AU - Kiemeney, Lambertus A.
AU - Witjes, J. A.
AU - Lemmens, Valery E.P.P.
AU - van der Hoeven, Jacobus J.M.
AU - Desar, Ingrid M.E.
AU - Aben, Katja K.H.
AU - Verhoeven, Rob H.A.
AU - Boormans, Joost
AU - de Reijke, Theo
AU - Helder, Sipke
AU - van Leenders, Geert J.L.H.
AU - van Leliveld, Anna M.
AU - Meijer, Richard P.
AU - Mulder, Sasja
AU - Nooter, Ronald I.
AU - Noteboom, Juus L.
AU - Smilde, Tineke J.
AU - Vanderbosch, Guus W.J.
AU - van der Heijden, Antoine G.
AU - van der Heijden, Michiel S.
AU - van Moorselaar, Reindert J.A.
AU - van Roermund, Joep G.H.
AU - Wijsman, Bart P.
AU - van Hoogstraten, Lisa M.C.
N1 - Publisher Copyright:
© 2022 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.
PY - 2023/2
Y1 - 2023/2
N2 - Objectives: To investigate the role of specialised genitourinary multidisciplinary team meetings (MDTMs) in decision-making and identify factors that influence the probability of receiving a treatment plan with curative intent for patients with muscle invasive bladder cancer (MIBC). Patients and methods: Data relating to patients with cT2-4aN0/X-1 M0 urothelial cell carcinoma, diagnosed between November 2017 and October 2019, were selected from the nationwide, population-based Netherlands Cancer Registry (‘BlaZIB study’). Curative treatment options were defined as radical cystectomy (RC) with or without neoadjuvant chemotherapy, chemoradiation or brachytherapy. Multilevel logistic regression analyses were used to examine the association between MDTM factors and curative treatment advice and how this advice was followed. Results: Of the 2321 patients, 2048 (88.2%) were discussed in a genitourinary MDTM. Advanced age (>80 years) and poorer World Health Organization performance status (score 1–2 vs 0) were associated with no discussion (P < 0.001). Being discussed was associated with undergoing treatment with curative intent (odds ratio [OR] 3.0, 95% confidence interval [CI] 1.9–4.9), as was the involvement of a RC hospital (OR 1.70, 95% CI 1.09–2.65). Involvement of an academic centre was associated with higher rates of bladder-sparing treatment (OR 2.05, 95% CI 1.31–3.21). Patient preference was the main reason for non-adherence to treatment advice. Conclusions: For patients with MIBC, the probability of being discussed in a MDTM was associated with age, performance status and receiving treatment with curative intent, especially if a representative of a RC hospital was present. Future studies should focus on the impact of MDTM advice on survival data.
AB - Objectives: To investigate the role of specialised genitourinary multidisciplinary team meetings (MDTMs) in decision-making and identify factors that influence the probability of receiving a treatment plan with curative intent for patients with muscle invasive bladder cancer (MIBC). Patients and methods: Data relating to patients with cT2-4aN0/X-1 M0 urothelial cell carcinoma, diagnosed between November 2017 and October 2019, were selected from the nationwide, population-based Netherlands Cancer Registry (‘BlaZIB study’). Curative treatment options were defined as radical cystectomy (RC) with or without neoadjuvant chemotherapy, chemoradiation or brachytherapy. Multilevel logistic regression analyses were used to examine the association between MDTM factors and curative treatment advice and how this advice was followed. Results: Of the 2321 patients, 2048 (88.2%) were discussed in a genitourinary MDTM. Advanced age (>80 years) and poorer World Health Organization performance status (score 1–2 vs 0) were associated with no discussion (P < 0.001). Being discussed was associated with undergoing treatment with curative intent (odds ratio [OR] 3.0, 95% confidence interval [CI] 1.9–4.9), as was the involvement of a RC hospital (OR 1.70, 95% CI 1.09–2.65). Involvement of an academic centre was associated with higher rates of bladder-sparing treatment (OR 2.05, 95% CI 1.31–3.21). Patient preference was the main reason for non-adherence to treatment advice. Conclusions: For patients with MIBC, the probability of being discussed in a MDTM was associated with age, performance status and receiving treatment with curative intent, especially if a representative of a RC hospital was present. Future studies should focus on the impact of MDTM advice on survival data.
UR - http://www.scopus.com/inward/record.url?scp=85135538067&partnerID=8YFLogxK
U2 - 10.1111/bju.15856
DO - 10.1111/bju.15856
M3 - Article
C2 - 35861125
AN - SCOPUS:85135538067
SN - 1464-4096
VL - 131
SP - 244
EP - 252
JO - BJU International
JF - BJU International
IS - 2
ER -
