Utility of a Multi-disciplinary Team Conference
Considering the complexity of head and neck oncologic care, a multidisciplinary team (MDT) approach in diagnosis, treatment, and survivorship care is essential. The MDT is generally composed of a diverse set of specialists: ablative and reconstructive surgeons, radiation oncologists, medical oncologists, neuroradiologists, pathologists, supportive and palliative care staff, speech language pathologists, nutritionists, dentists, and physical and occupational therapists1-4. As head and neck oncologic staging and treatment paradigms continue to evolve, there is a significant emphasis on the value of a specialized multidisciplinary conference (MDC)5. The inherent purpose of MDC is to serve as a quality checkpoint: to ensure a thorough evaluation of each case regardless of the spectrum of care, whether pre-treatment, treatment, or survivorship. This entails ensuring proper diagnosis, staging, treatment planning, clinical trial enrollment, care coordination, management of treatment complications, evaluating disease response, recurrence monitoring, and survivorship outcomes4. There is strong evidence to suggest that MDC implementation may improve pre-treatment evaluation (dental, nutrition)6, proper staging7,8, and appropriate timely treatment6-11. It may also affect disease specific survival11,12 and overall survival10-15 but this is controversial. As MDC usage has become more widespread, academic institutions are beginning to evaluate MDC quality measures with respect to guideline adherence and patient outcomes13. Given its impact, MDC has become a standard in head and neck oncologic care.