Vol.:(0123456789) 1 3 Medical Oncology (2019) 36:2 https://doi.org/10.1007/s12032-018-1227-z REVIEW ARTICLE Multidisciplinary team in head and neck cancer: a management model F. De Felice 1  · V. Tombolini 1  · M. de Vincentiis 2  · G. Magliulo 3  · A. Greco 3  · V. Valentini 2  · A. Polimeni 2 Received: 22 October 2018 / Accepted: 6 November 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Nowadays, the multidisciplinary team (MDT) is an essential component for oncologic disease management. Its benefit is also extensively recognized in head and neck cancer (HNC) community, due to tumor rarity and complex treatment. A well-defined MDT management serves as a stable point to define the better strategy and offers a chance to optimize HNC clinical outcomes and patient’s quality of life. We explored both mandatory and additional requirements for establishing a high-quality MDT. Then we proposed an example of HNC MDT organization. The aim is to contribute to the best way to systematize HNC care. Keywords Head and neck cancer · Multidisciplinary team · Quality of life · Management · Requirements · Organization Introduction Head and neck cancer (HNC) is a heterogeneous group of malignancies, accounting for approximately 5% of all cancers cases [1]. In Italy, 9300 new HNC cases and 2820 deaths from HNC are projected to occur annually [2]. Due to its rarity, the delivery of HNC services should be cen- tralized at centers with expertise and should be in any case considered responsibility of the public sector [3]. In fact HNC requires complex treatment and a multidisciplinary team (MDT) approach involving different professional fig- ures from all relevant specialties is paramount. HNC risk, as well as HNC prognosis, mainly depends on bad habits, including tobacco and alcohol abuse, and virus infections, such as human papilloma virus (HPV) and Epstein–Barr virus (EBV) [4, 5]. Each HNC patient needs an individualized medical decision process in order to receive the more appropriate counseling, treatment, and supportive care options. This decisional process should be based on a well-established care setting mechanism. In this work, we provided a comprehensive description of the essential requirements in the effort to bridge the daily MDT clinical practice to the necessary organizational skills at all levels in the management of HNC patients. Based on the statement “doing the right thing, at the right time, in the right way, for the right person” [6], we highlighted the gap between what we have and what we know to be effective and beneficial. The aim is to improve quality of care and the hope is to plan changes effectively. Head and neck cancer: current situation In general, HNC management is complex and includes sur- gery (S), radiation therapy (RT), chemotherapy (C), or a combination of these modalities [7]. Proper approach mainly depends on stage of disease at diagnosis and primary tumor location. Primary S is performed in oral cavity cancer and, in case of pathological T3-4, N2-3 nodal disease, positive surgical margins, extracapsular nodal spread, perineural invasion, and lymphovascular invasion, an adjuvant treat- ment is required [8]. Primary definitive RT is usually con- sidered in the remainder HNC cancer sites, especially in locally advanced stage disease in order to propose an organ preservation strategy [8]. For sure, significant expertise is required from different health care professionals not only due to proximity to diverse * F. De Felice fradefelice@hotmail.it 1 Department of Radiotherapy, Policlinico Umberto I, “Sapienza” University of Rome, Viale Regina Elena 326, Rome, Italy 2 Department of Oral and Maxillo Facial Sciences, Policlinico Umberto I “Sapienza” University of Rome, Rome, Italy 3 Department of Sense Organs, Policlinico Umberto I “Sapienza” University of Rome, Rome, Italy