Background: The germ cell supranetwork multidisciplinary team (SMDT) for the Anglian Network covers a population of 7.5 million.
Methods: We reviewed 10 years of SMDT discussion and categorised them into five domains ((1) overall outcome, (2) chemotherapy regimens-untreated disease and salvage therapy, (3) radiology, (4) pathology and (5) complex cases) to assess the impact of the SMDT.
Results: A total of 2892 new cases were reviewed. In the first 5 years, patients with good prognosis disease had poorer survival in low-volume vs high-volume centres (87.8 vs 95.3, p = 0.02), but the difference was no longer significant in the last 5 years (93.3 vs 95.1, p = 0.30). Radiology review of 3206 scans led to rejection of the diagnosis of progression in 26 cases and a further 10 cases were down-staged. There were 790 pathology reviews by two specialised uropathologists, which lead to changes in 75 cases. F-fluorodeoxyglucose (FDG) PET-CT was undertaken during this time period but did not help to predict who would have viable cancer. A total of 26 patients with significant mental health issues who were unable to give informed consent were discussed.
Conclusion: SMDT working has led to an improvement in outcomes and refining of treatment in patients with germ cell tumours.
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| http://dx.doi.org/10.1038/s41416-020-01075-1 | DOI Listing |
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