Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings

Background: Multidisciplinary team (MDT) meetings are a gold standard in lung cancer care. A recent study identified discrepancies in staging and treatment recommendations among Danish lung cancer MDTs based on fictitious cases. This short report presents the results from a national lung cancer MDT...

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Main Authors: Anja Gouliaev, Weronika Maria Szejniuk, Joan Fledelius, Hans Henrik Torp Madsen, Rene Horsleben Petersen, Torben Riis Rasmussen
Format: Article
Language:English
Published: Medical Journals Sweden 2025-06-01
Series:Acta Oncologica
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Online Access:https://medicaljournalssweden.se/actaoncologica/article/view/43314
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author Anja Gouliaev
Weronika Maria Szejniuk
Joan Fledelius
Hans Henrik Torp Madsen
Rene Horsleben Petersen
Torben Riis Rasmussen
author_facet Anja Gouliaev
Weronika Maria Szejniuk
Joan Fledelius
Hans Henrik Torp Madsen
Rene Horsleben Petersen
Torben Riis Rasmussen
author_sort Anja Gouliaev
collection DOAJ
description Background: Multidisciplinary team (MDT) meetings are a gold standard in lung cancer care. A recent study identified discrepancies in staging and treatment recommendations among Danish lung cancer MDTs based on fictitious cases. This short report presents the results from a national lung cancer MDT meeting, which reevaluated these difficult cases. Method: Fifteen difficult cases were reevaluated by 52 lung cancer specialists from across Denmark, representing oncology, pulmonology, radiology, nuclear medicine, and thoracic surgery. Participants were grouped together with their usual MDT colleagues. Cases were presented in a plenary session, and participants discussed cases staging, treatment intent, and treatment options as they would in a regular MDT with their colleagues. If disagreement between the individual MDT groups occurred, the case was further discussed in plenum. Descriptive statistics were used to assess agreement. Results: Complete agreement on tumor node metastasis (TNM) staging, treatment intent, and recommended treatment was reached in three cases (20%). Agreement on stage was reached in 10 cases (67%). Discrepancies regarding stage arose from debates regarding multifocal versus synchronous lung cancers, degree of lymph node involvement and the malignancy status of pleural fluid. Differences in treatment recommendations were mainly due to insufficient information about performance status. Interpretation: Staging and treatment intent discrepancies among Danish lung cancer MDTs were considerably reduced when complex cases were discussed in a national plenary session. However, for difficult lung cancer cases, MDTs recommend different treatment, highlighting the need for a national MDT meeting for a select group of lung cancer patients.
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spelling doaj-art-59888f12c97748caa2be72a61ba08c582025-08-20T03:31:23ZengMedical Journals SwedenActa Oncologica1651-226X2025-06-016410.2340/1651-226X.2025.43314Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetingsAnja Gouliaev0https://orcid.org/0000-0002-6161-5936Weronika Maria Szejniuk1https://orcid.org/0000-0001-6790-6710Joan Fledelius2https://orcid.org/0000-0002-7825-7418Hans Henrik Torp Madsen3Rene Horsleben Petersen4https://orcid.org/0000-0002-3586-1869Torben Riis Rasmussen5https://orcid.org/0000-0002-7030-9260aDepartment of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Oncology & Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, DenmarkDepartment of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, DenmarkDepartment of Radiology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, DenmarkDepartment of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; The Danish Lung Cancer Group, Aarhus, DenmarkBackground: Multidisciplinary team (MDT) meetings are a gold standard in lung cancer care. A recent study identified discrepancies in staging and treatment recommendations among Danish lung cancer MDTs based on fictitious cases. This short report presents the results from a national lung cancer MDT meeting, which reevaluated these difficult cases. Method: Fifteen difficult cases were reevaluated by 52 lung cancer specialists from across Denmark, representing oncology, pulmonology, radiology, nuclear medicine, and thoracic surgery. Participants were grouped together with their usual MDT colleagues. Cases were presented in a plenary session, and participants discussed cases staging, treatment intent, and treatment options as they would in a regular MDT with their colleagues. If disagreement between the individual MDT groups occurred, the case was further discussed in plenum. Descriptive statistics were used to assess agreement. Results: Complete agreement on tumor node metastasis (TNM) staging, treatment intent, and recommended treatment was reached in three cases (20%). Agreement on stage was reached in 10 cases (67%). Discrepancies regarding stage arose from debates regarding multifocal versus synchronous lung cancers, degree of lymph node involvement and the malignancy status of pleural fluid. Differences in treatment recommendations were mainly due to insufficient information about performance status. Interpretation: Staging and treatment intent discrepancies among Danish lung cancer MDTs were considerably reduced when complex cases were discussed in a national plenary session. However, for difficult lung cancer cases, MDTs recommend different treatment, highlighting the need for a national MDT meeting for a select group of lung cancer patients. https://medicaljournalssweden.se/actaoncologica/article/view/43314lung cancerScandinavian and Nordic countriesmultidisciplinary team conferencetumor boardconsensus
spellingShingle Anja Gouliaev
Weronika Maria Szejniuk
Joan Fledelius
Hans Henrik Torp Madsen
Rene Horsleben Petersen
Torben Riis Rasmussen
Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
Acta Oncologica
lung cancer
Scandinavian and Nordic countries
multidisciplinary team conference
tumor board
consensus
title Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
title_full Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
title_fullStr Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
title_full_unstemmed Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
title_short Discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
title_sort discrepancies in regional lung cancer multidisciplinary team decisions can be reduced through national consensus meetings
topic lung cancer
Scandinavian and Nordic countries
multidisciplinary team conference
tumor board
consensus
url https://medicaljournalssweden.se/actaoncologica/article/view/43314
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