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Effectiveness of a thoracic multidisciplinary clinic in the treatment of stage III non-small-cell lung cancer

Authors Friedman EL, Kruklitis RJ, Patson BJ, Sopka DM, Weiss MJ

Received 15 October 2015

Accepted for publication 13 February 2016

Published 13 June 2016 Volume 2016:9 Pages 267—274

DOI https://doi.org/10.2147/JMDH.S98345

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Devang Sanghavi

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Video abstract presented by Eliot L Friedman

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Eliot L Friedman,1 Robert J Kruklitis,2 Brian J Patson,1 Dennis M Sopka,3 Michael J Weiss4

1Division of Hematology-Medical Oncology, 2Division of Pulmonary and Critical Care Medicine, 3Department of Radiation Oncology, 4Health Systems Research and Innovation, Lehigh Valley Health Network, Allentown, PA, USA

Introduction: The Institute of Medicine, the American Society of Clinical Oncology, and the European Society of Medical Oncology promote a multidisciplinary approach for the treatment of cancer. Stage III non-small-cell lung cancer (NSCLC) represents a heterogeneous group of diseases necessitating coordination of care among medical, radiation, and surgical oncology. The optimal care of stage III NSCLC underscores the need for a multidisciplinary approach.
Methods: From tumor registry data, we identified all cases of stage III NSCLC seen at Lehigh Valley Health Network between March 2010 and March 2013. The care received by patients when seen in the thoracic multidisciplinary clinic (MDC) was compared with the care received when not seen in the thoracic MDC.
Results: All patients seen in the MDC, compared to <50% of patients seen outside the MDC, were evaluated by more than one physician prior to beginning the treatment. Time to initiate treatment was shorter in MDC patients than in non-MDC patients. Patients seen in the MDC had a greater concordance with clinical pathways. A greater percentage of patients seen in the thoracic MDC had pathologic staging of their mediastinum. Patients seen in the MDC were more likely to receive all of their care at Lehigh Valley Health Network.
Conclusion: Multidisciplinary care is essential in the treatment of patients with stage III NSCLC. Greater utilization of MDCs for this complex group of patients will result in more efficient coordination of care, pretreatment evaluation, and therapy, which in turn should translate to improve patients' outcomes.

Keywords: lung cancer, multidisciplinary care, clinical pathways

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