1Department of Medicine, Nowon Eulji Medical Center, Eulji University, Eulji University School of Medicine, Seoul, Korea
2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
© 2024 The Korean Liver Cancer Association.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflict of Interest
Dong Hyun Sinn is an editorial board member of Journal of Liver Cancer, and was not involved in the review process of this article. Otherwise, the authors have no conflicts of interest to disclose.
Ethics Statement
This review article is fully based on articles which have already been published and did not involve additional patient participants. Therefore, IRB approval is not necessary.
Funding Statement
None.
Data Availability
Not applicable.
Author Contribution
Conceptualization: DHS
Investigation: JHO, DHS
Resources: JHO
Writing - original draft: JHO
Writing - review & editing: DHS
HCC, hepatocellular carcinoma; EASL, European Association for the Study of the Liver; BCLC, Barcelona Clinic Liver Cancer; KLCA-NCC, Korean Liver Cancer Association-National Cancer Center; AASLD, American Association for the Study of Liver Diseases; LR, liver imaging-reporting and data system; TACE, transarterial chemoembolization; SIRT, selective internal radiation therapy.
Study | Country | Study design | Sample size | Intervention | Specialized department convened | Topic discussed | Frequency |
---|---|---|---|---|---|---|---|
Chang et al.14 (2008) | USA | Retrospective | 121 | MDT | Hepatologists, oncologists, radiologists, and surgeons | Imagining and pathology interpretation, diagnosis, management | N/A |
Wiggans et al.13 (2013) | UK | Retrospective | 438 | MDT | Radiologists, oncologists, surgeons, and physicians | Radiological, pathological diagnosis differ | 1 week |
Yopp et al.15 (2014) | USA | Retrospective | 355 | MDT | Physicians from surgical oncology, transplant hepatology, interventional radiology, diagnostic radiology, radiation oncology, medical oncology | Imagining and pathology interpretation, diagnosis, management | 1 week |
Zhang et al.12 (2013) | USA | Retrospective | 343 | MDT | Surgical oncologist, medical oncologist, radiation oncologist, radiologist, pathologist, interventional radiologist, hepatologist, and transplant surgeon | Imaging and pathology interpretation, diagnosis, and management plan | Occasionally |
Gashin et al.18 (2014) | USA | Retrospective | 137 | MDT | Five hepatologists, three oncologists, one radiation oncologist, three interventional radiologists, one pathologist, three surgeons, three radiologists, and five mid-level staff including nurses, nurse practitioners and physician assistants | Imaging and pathology interpretation, diagnosis, and management plan | 1 week |
Chirikov et al.20 (2015) | USA | Retrospective | 3,588 | Multispecialty (3 or more specialists) | Surgeons, radiology oncologist, intervention radiologist, hematologist/medical oncologist, gastroenterologist, and generalist | Imaging and pathology interpretation, diagnosis, and management plan | N/A |
Charriere et al.31 (2017) | France | Retrospective | 387 | MDT | Senior physicians, specialized in hepatology, oncology, hepatobiliary surgery, transplantation, and radiology | Treatment | 1 week |
Agarwal et al.33 (2017) | USA | Retrospective | 655 | MDT | Transplant hepatologists, medical oncologists, hepatobiliary and transplant surgeons, pathologists, diagnostic, and interventional radiologists | Imaging and pathology interpretation, diagnosis, and management plan | 1 week |
Serper et al.23 (2017) | USA | Retrospective | 3,988 | MDT | Hepatologists, gastroenterologists, surgeons, oncologists | Treatment | N/A |
Kaplan et al.16 (2018) | USA | Retrospective | 3,188 | MDT | Hepatologists, gastroenterologists, surgeons, oncologists | N/A | N/A |
Duininck et al.32 (2019) | USA | Retrospective | 204 | MDT | Surgical oncologist, interventional radiologist, hepatologist, medical oncologists, radiation oncologists, and internal medicine physicians | Imaging and pathology interpretation, diagnosis, and management plan | N/A |
Sinn et al.17 (2019) | Korea | Retrospective | 6,619 | MDT | Hepatologists, surgeons, diagnostic radiologists, interventional radiologists specialized at local ablation therapies, interventional radiologists specialized at transarterial embolotherapies, radiation oncologists, medical oncologists, pathologists and coordinators | Imaging and pathology interpretation, diagnosis, and management plan | 1 week |
Tseng et al.21 (2023) | Taiwan | Retrospective | 32,784 | MDT | Integrated medical staff in each category | N/A | N/A |
Study | Etiology | Stage | Sample size (MDT vs. non-MDT) | Control | Follow-up periods (months) | Outcome (treatment) | Outcome (mortality) | Who benefits the most? |
---|---|---|---|---|---|---|---|---|
Chang et al.14 (2008) | HCV (69%) | AJCC stage I-IV | 183 (121 vs. 62) | Pre-MDT (previous 3 years) | 9.5 vs. 4.5 | Receiving curative treatment (19% vs. 6%, P<0.001) | Survival rate during follow-up periods (65% vs. 21%, P<0.001) | AJCC stage II and IV |
Yopp et al.15 (2014) | HCV (60%) | BCLC A-D | 355 (105 vs. 250) | Pre-MDT (previous 4 years) | 7.9 vs. 4.2 | Receiving curative treatment (21% vs. 10%, P=0.006) | Adjusted HR 2.5 (2-3) for overall survival | BCLC B, C, and D |
Gashin et al.18 (2014) | HCV (62%) | N/A | 137 (N/A) | Non-adherence to MDT decision | N/A | Receiving liver transplantation (25.6%vs.14.4%,P=0.10) | 1 year survival rate (61.7% vs. 56.7%, P=0.29) | N/A |
Chirikov et al.20 (2015) | HCV | Cancer stage 1-4 | 3,588 (1,434 vs. 811) | One discipline | N/A | Higher rate of liver-directed, radiation, and transplant, and low rate of resection and chemotherapy (P<0.001) | Adjusted HR 0.90 (P=0.04) | Chemotherapy recipients |
Charriere et al.31 (2017) | Alcohol (40%) | BCLC 0-D | 387 (255 vs. 132) | Not following MDT decision | 27.5 | N/A | Adjusted HR 0.39 (95% CI, 0.27-0.54) | MELD <10 |
Agarwal et al.33 (2017) | N/A | T2 stage (36%) | 655 (306 vs. 349) | Not managed through MDT | N/A | Receiving any treatment (OR, 2.80; 95% CI, 1.71-4.59) | Adjusted HR 0.72 (95% CI, 0.55-0.94) | T2 tumor stage |
Serper et al.23 (2017) | HCV and alcohol (39%) | BCLC 0-D | 3,988 (1,366 vs. 2,622) | Not managed through MDT | 1.1* | Receiving active HCC therapy (OR, 1.19; 95% CI, 0.98-1.46) | Adjusted HR 0.83 (95% CI, 0.77-0.90) | N/A |
Kaplan et al.16 (2018) | HCV and alcohol (39%) | BCLC 0-D | 3,188 (2,062 vs. 1,121) | Not managed through MDT | N/A | N/A | Mean survival (597.4 vs. 471.9 days) | N/A |
Duininck et al.32 (2019) | HCV | BCLC 1-4 | 204 (134 vs. 70) | Pre-MDT | N/A | Receiving surgery (49% vs. 30%, P=0.02) | Adjusted HR 0.62 (95% CI, 0.40-0.98) | N/A |
Sinn et al.17 (2019) | HBV (76.3%) | BCLC 0-D | 6,619 (738 vs. 5,881) | Pre-MDT | 3.5* | Receiving curative treatment (48.1% vs. 55.9%) | Adjusted HR 0.47 (95% CI, 0.41-0.53) | ALBI grade 2, 3 |
BCLC B, C | ||||||||
High AFP ≥200 ng/mL | ||||||||
Tseng et al.21 (2023) | HBV or HCV | BCLC 0-D | 32,784 (10,928 vs. 21,856) | Not managed through MDT | N/A | N/A | Adjusted HR 0.88 (95% CI, 0.84-0.92) | BCLC B, C |
MDT, multidisciplinary team; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; AJCC, American Joint Committee on Cancer; BCLC, Barcelona Clinic Liver Cancer; HR, hazard ratio; N/A, not assessed; MELD, model for end-stage liver disease; OR, odds ratio; CI, confidence interval; ALBI, albumin-bilirubin; AFP, alpha-fetoprotein.
* years.