Introduction Mesothelioma is an uncommon malignancy with a poor prognosis, and in order to improve its management all cases within each cancer network should be discussed at a specialist MDT, which advises individual cancer units on the best treatment approach for their patients. The regional specialist mesothelioma MDT for the Mersey and Cheshire Cancer Network (MCCN) was incorporated in 2009, and we were interested to assess the effect this had on the outcome of mesothelioma patients attending our large cancer unit.
Method We compared clinical parameters for all our mesothelioma patients before and after the inception of the specialist MDT, looking at symptoms, investigations carried out, the histological rate and type, and treatments offered.
Results Fifty five patients were diagnosed between 2007 and 2011(mean age 75 years [SD 7.35], median WHO performance status 1, 46 male). Most (85%) were symptomatic at presentation–18 (32%) had chronic cough, 27 (49%) pain and 38 (69%) dyspnoea. 23 (42%) had documented asbestos exposure. Diagnosis was made clinically in 1 patient and by cytology alone in 4 patients.
Diagnostic methodology and treatment modalities for the 2-year periods before (2007–8) and after (2010–11) the specialist MDT formation are given in the table (Table 1). There was no difference in histological rates (100% and 92% respectively) or cell types between the two periods.
Conclusions In the second time period, our use of radical oncological treatment increased and at the same time extensive surgical treatment decreased, in keeping with current considered best practice. These changes in clinical practice coincided with discussion of these cases at the newly formed MCCN specialist mesothelioma MDT. This study emphasises the value of an expert multidisciplinary approach to the management of this unfortunate group of patients.
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