Revisión narrativa sobre Comité de Tumores de Oncología Torácica
Barra lateral del artículo
Contenido principal del artículo
Resumen
Introducción: Un Comité de Tumores de Oncología Torácica (CTOT) es un equipo multidisciplinario que revisa casos de pacientes, discute enfoques terapéuticos y desarrolla planes personalizados, considerando el tipo de cáncer, estadio, condición general y preferencias del paciente individual.
Objetivos: Actualizar la evidencia y ofrecer pautas para la implementación o mejora de los CTOT, analizando factores clave como la preparación, estructura, registro de datos y medición de resultados.
Resultados: La revisión narrativa destaca que el CTOT se conforma de un núcleo básico de especialidades (oncológica torácica, neumonología, cirugía torácica, oncología radiante, radiología intervencionista, diagnóstico por imágenes, medicina nuclear y anatomía patológica) y un equipo extendido que puede eventualmente ser citado a demanda (ej: trabajadora social, médicos de cabecera, paliativos). La frecuencia de las reuniones es generalmente semanal, en función del volumen de casos, con opciones presenciales, virtuales y/o híbridas.
Una infraestructura adecuada es crucial para el funcionamiento correcto y eficiente, incluyendo protocolos para la selección y la presentación de casos, normas claras para la dinámica de reuniones, un proceso de toma de decisiones basado en respeto y comunicación, y un sistema de documentación que garantice la confidencialidad. Además, se subraya la importancia de medir los resultados mediante indicadores de calidad.
Conclusión: Un sistema eficiente en los CTOT permite la recopilación de datos y su uso en investigación y auditorías internas, lo que asegura un mejor manejo de los pacientes.
Descargas
Detalles del artículo
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Citas
Del Giudice ME, Young SM, Vella ET et al. Guideline for referral of patients with suspected lung cancer by family physicians and other primary care providers. Can Fam Physician 2014;60(8):711–6, e376–82.
Fleissig A, Jenkins V, Catt S, Fallowfield L. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol 2006;7(11):935–43. Doi: 10.1016/S1470-2045(06)70940-8.
Specchia ML, Frisicale EM, Carini E et al. The impact of tumor board on cancer care: evidence from an umbrella review. BMC Health Serv Res 2020;20(1):73. Doi: 10.1186/s12913-020-4930-3.
Quint LE, Reddy RM, Lin J et al. Imaging in thoracic oncology: case studies from Multidisciplinary Thoracic Tumor Board (part 1 of 2 part series). Cancer Imaging 2013;13(3):429–39. Doi: 10.1102/1470-7330.2013.0037.
Mainguene J, Basse C, Girard P et al. Surgical or medical strategy for locally-advanced, stage IIIA/B-N2 non-small cell lung cancer: Reproducibility of decision-making at a multidisciplinary tumor board. Lung Cancer 2022;163:51–8. Doi: 10.1016/j.lungcan.2021.12.004.
Kreidieh F, Tfayli A. Impact of thoracic multidisciplinary tumor boards on the management of patients with cancer: A retrospective study at the American university of Beirut medical center. Mol Clin Oncol 2023;18(1):6. Doi: 10.3892/mco.2022.2602.
Lamb B, Payne H, Vincent C, Sevdalis N, Green JSA. The role of oncologists in multidisciplinary cancer teams in the UK: an untapped resource for team leadership? J Eval Clin Pract 2011;17(6):1200–6. Doi: 10.1111/j.1365-2753.2010.01507.x.
Mäurer I, Drescher R, Hammersen J et al. Development and implementation of a student tumor board as a teaching format for medical students. J Cancer Res Clin Oncol 2023;149:16087-16096. Doi: 10.1007/s00432-023-05336-3.
Tho PC, Ang E. The effectiveness of patient navigation programs for adult cancer patients undergoing treatment: a systematic review. JBI Database System Rev Implement Rep 2016;14(2):295–321. Doi: 10.11124/jbisrir-2016-2324.
Guirado M, Sanchez-Hernandez A, Pijuan L, Teixido C, Gómez-Caamaño A, Cilleruelo-Ramos Á. Quality indicators and excellence requirements for a multidisciplinary lung cancer tumor board by the Spanish Lung Cancer Group. Clin Transl Oncol 2022;24(3):446–59. Doi: 10.1007/s12094-021-02712-8.
Demedts I, Himpe U, Bossuyt J et al. Clinical implementation of value based healthcare: Impact on outcomes for lung cancer patients. Lung Cancer 2021;162:90–5. Doi: 10.1016/j.lungcan.2021.10.010.
Lamot SB, Viola L, Rossini SA et al. Estandarización de requerimientos mínimos para la formación de centro de detección temprana de cáncer de pulmón en América Latina. Respirar 2024;16(1):31–43. Doi: 10.55720/respirar.16.1.4.
Diaz MH, Ibañez Ledesma LG, Torres Gomez F et al. Chemotherapy at the end of life is compatible with dignified death and palliative care. Rev Fac Cien Med Univ Nac Córdoba 2023;80(2):93–8. Doi: 10.31053/1853.0605.v80.n2.37489
Kochovska S, Ferreira DH, Luckett T, Phillips JL, Currow DC. Earlier multidisciplinary palliative care intervention for people with lung cancer: a systematic review and meta-analysis. Transl Lung Cancer Res 2020;9(4):1699–709. Doi: 10.21037/tlcr.2019.12.18.
Bertolaccini L, Mohamed S, Bardoni C et al. The Interdisciplinary Management of Lung Cancer in the European Community. J Clin Med Res 2022;11(15). Doi: 10.3390/jcm11154326.
Mayo Clinic. Weekly Tumor Boards. [Internet]. [Consultado 23 abr 2024]. Disponible en: https://ce.mayo.edu/tumorboard-mankato18/content/weekly-tumor-boards-62
Gebbia V, Guarini A, Piazza D et al. Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer. Pulm Ther 2021;7(2):295–308. Doi: 10.1007/s41030-021-00163-8.
Lamb BW, Sevdalis N, Arora S, Pinto A, Vincent C, Green JSA. Teamwork and team decision-making at multidisciplinary cancer conferences: barriers, facilitators, and opportunities for improvement. World J Surg 2011;35(9):1970–6. Doi: 10.1007/s00268-011-1152-1.
Blasi L, Bordonaro R, Serretta V, Piazza D, Firenze A, Gebbia V. Virtual Clinical and Precision Medicine Tumor Boards-Cloud-Based Platform-Mediated Implementation of Multidisciplinary Reviews Among Oncology Centers in the COVID-19 Era: Protocol for an Observational Study. JMIR Res Protoc 2021;10(9):e26220. Doi: 10.2196/26220.
Munro AJ, Swartzman S. What is a virtual multidisciplinary team (vMDT)? Br J Cancer 2013;108(12):2433–41. Doi: 10.1038/bjc.2013.231.
Karas PL, Rankin NM, Stone E. Medicolegal Considerations in Multidisciplinary Cancer Care. JTO Clin Res Rep 2020;1(4):100073. Doi: 10.1016/j.jtocrr.2020.100073.
Hamilton DW, Heaven B, Thomson RG, Wilson JA, Exley C. Multidisciplinary team decision-making in cancer and the absent patient: a qualitative study. BMJ Open 2016;6(7):e012559. Doi: 10.1136/bmjopen-2016-012559.
Heuser C, Diekmann A, Schellenberger B et al. Patient Participation in Multidisciplinary Tumor Conferences from the Providers’ Perspective: Is It Feasible in Routine Cancer Care? J Multidiscip Healthc 2020;13:1729–39. Doi: 10.2147/JMDH.S283166.
Diekmann A, Heuser C, Schellenberger B et al. Patient participation in multidisciplinary tumor conferences: Providers’ perceptions of patients' need satisfaction and emotional experiences. Psychooncology 2020;29(8):1263–71. Doi: 10.1002/pon.5413.
Merker L, Conroy S, El-Wakeel H, Laurence N. Streamlining the Multi-Disciplinary Team Meeting: The Introduction of Robust Pre-Preparation Methods and Its Effect on the Length of Case Discussions. J Multidiscip Healthc 2023;16:613–22. Doi: 10.2147/JMDH.S387174.
Stone E, Rankin NM, Vinod SK et al. Clinical impact of data feedback at lung cancer multidisciplinary team meetings: A mixed methods study. Asia Pac J Clin Oncol 2020;16(1):45–55. Doi: 10.1111/ajco.13278.
Freeman RK, Ascioti AJ, Dake M, Mahidhara RS. The Effects of a Multidisciplinary Care Conference on the Quality and Cost of Care for Lung Cancer Patients. Ann Thorac Surg 2015;100(5):1834–8; discussion 1838. Doi: 10.1016/j.athoracsur.2015.05.056.
Rollet Q, Bouvier V, Moutel G et al. Multidisciplinary team meetings: are all patients presented and does it impact quality of care and survival - a registry-based study. BMC Health Serv Res 2021;21(1):1032. Doi: 10.1186/s12913-021-07022-x.
Mano MS, Çitaku FT, Barach P. Implementing multidisciplinary tumor boards in oncology: a narrative review. Future Oncol 2022;18(3):375–84. Doi: 10.2217/fon-2021-0471.
Wihl J, Rosell L, Frederiksen K, Kinhult S, Lindell G, Nilbert M. Contributions to Multidisciplinary Team Meetings in Cancer Care: Predictors of Complete Case Information and Comprehensive Case Discussions. J Multidiscip Healthc 2021;14:2445–52. Doi: 10.2147/JMDH.S309162.
Wihl J. Multidisciplinary Team Meetings in Cancer Care Case Discussions, Patient Selection, Leadership. [Doctoral Thesis (compilation), Department of Clinical Sciences, Lund] Lund University, Faculty of Medicine; 2022 [Consultado 6 oct 2023]. Disponible en: https://lucris.lub.lu.se/ws/portalfiles/portal/126896716/Multidisciplinary_team_meetings_in_cancer_care_case_discussions_patient_selection_leadership_Jessica_Wihl.pdf
Shea CM, Teal R, Haynes-Maslow L et al. Assessing the feasibility of a virtual tumor board program: a case study. J Healthc Manag 2014;59(3):177–93.
Budde H, Williams GM (Of European Observatory on Health Systems and Policies), Scarpetti G, Kroezen M, Maier CB. What are Patient Navigators and how Can They Improve Integration of Care? European Observatory on Health Systems and Policies 2022. pp. 28. Disponible en: https://books.google.com/books/about/What_are_Patient_Navigators_and_how_Can.html?hl=&id=I0X6zgEACAAJ
Dalton M, Holzman E, Erwin E et al. Patient navigation services for cancer care in low-and middle-income countries: A scoping review. PLoS One 2019;14(10):e0223537. Doi: 10.1371/journal.pone.0223537.
Guidance for Implementing High-quality Multidisciplinary Meetings: Achieving Best Practice Cancer Care. Ministry of Health, 2012. pp 22. Disponible en: https://books.google.com/books/about/Guidance_for_Implementing_High_quality_M.html?hl=&id=3D2UtgEACAAJ
Schmidt HM, Roberts JM, Bodnar AM et al. Thoracic multidisciplinary tumor board routinely impacts therapeutic plans in patients with lung and esophageal cancer: a prospective cohort study. Ann Thorac Surg 2015;99(5):1719–24. Doi: 10.1016/j.athoracsur.2014.11.019.
Gossot D, Saiydoun G, Leclerc JB et al. Thoracic surgery in France. J Thorac Dis 2022;14(7):2721–7. Doi: 10.21037/jtd-21-1462.
Thalanayar Muthukrishnan P, Ratnam M, Nguyen MT et al. Pre-diagnosis Multidisciplinary Tumor Board and Time to Staging in Lung Cancer: The Case Western MetroHealth Experience. Cureus 2020;12(1):e6595. Doi: 10.7759/cureus.6595.
Zou J, Xu X, Wang D, Xu J, Gu W. The impacts of the multidisciplinary team model on the length of stay and hospital expenses of patients with lung cancer. Zhonghua Jie He He Hu Xi Za Zhi 2015;38(5):370–4.
Stone E, Rankin N, Kerr S et al. Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung Cancer 2018;124:199–204. Doi: 10.1016/j.lungcan.2018.07.032.
Rangabashyam M, Wee HE, Wang W et al. Electronic tumor board presentations as the basis for the development of a head and neck cancer database. Laryngoscope Investig Otolaryngol 2020;5(1):46–54. Doi: 10.1002/lio2.337.
Liu Y, Evans L, Kwan T et al. Developing a maturity model for cancer multidisciplinary teams. Int J Med Inform 2021;156:104610. Doi: 10.1016/j.ijmedinf.2021.104610.
Evans L, Donovan B, Liu Y, Shaw T, Harnett P. A tool to improve the performance of multidisciplinary teams in cancer care. BMJ Open Qual 2019;8(2):e000435. Doi: 10.1136/bmjoq-2018-000435.
Brown GTF, Bekker HL, Young AL. Quality and efficacy of Multidisciplinary Team (MDT) quality assessment tools and discussion checklists: a systematic review. BMC Cancer 2022;22(1):286. Doi: 10.1186/s12885-022-09369-8.
Harris J, Taylor C, Sevdalis N, Jalil R, Green JSA. Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT). Int J Qual Health Care 2016;28(3):332–8. Doi: 10.1093/intqhc/mzw030.
Takeda T, Takeda S, Uryu K et al. Multidisciplinary Lung Cancer Tumor Board Connecting Eight General Hospitals in Japan via a High-Security Communication Line. JCO Clin Cancer Inform 2019;3:1–7. Doi: 10.1200/CCI.18.00115.