The impact of a supranetwork multidisciplinary team (SMDT) on decision-making in testicular cancers: a 10-year overview of the Anglian Germ Cell Cancer Collaborative Group (AGCCCG).

The germ cell supranetwork multidisciplinary team (SMDT) for the Anglian Network covers a population of 7.5 million.

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.

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. 18F-fluorodeoxyglucose (18FDG) 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.

SMDT working has led to an improvement in outcomes and refining of treatment in patients with germ cell tumours.

British journal of cancer. 2020 Sep 29 [Epub ahead of print]

Jonathan Shamash, Wendy Ansell, Constantine Alifrangis, Benjamin Thomas, Peter Wilson, Sara Stoneham, Danish Mazhar, Anne Warren, Tristan Barrett, Susanna Alexander, Sarah Rudman, Michelle Lockley, Daniel Berney, Anju Sahdev

Barts Health NHS Trust, London, UK. ., Barts Health NHS Trust, London, UK., Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., University College London Hospitals, London, UK., Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK., Guy's & St Thomas' NHS Foundation Trust, London, UK., Centre for Cancer Cell and Molecular Biology, Barts Cancer Institute, Queen Mary University of London, London, UK.

email news signup