在荷兰，根据诊断医院接受治愈性治疗的可能性因食道癌而异。对造成这种变化的因素知之甚少。本研究旨在提高对多学科团队会议治疗方案与实际进行的治疗之间差异的理解，并定性调查医院之间多学科团队会议治疗方案后治疗决策的差异。
为了深入了解治疗决策，定量数据(即，多学科小组会议提案和进行的治疗）从荷兰癌症登记处收集。多学科小组会议提案和应用治疗的变化包括治疗方案类型的变化(即，治愈性或姑息性，或无变化)，并根据接受治愈性治疗的多变量多级概率(低，中间,和高）。定性数据来自八家医院，包括26次门诊咨询的观察，与临床医生进行了30次深入访谈，有临床医生的七个焦点小组，和三个重点人群。使用主题内容分析评估临床医生和患者的观点。
在97%的病例中，多学科小组会议建议和应用治疗是一致的。临床医生在临床实践中实施治疗决策的方式多种多样，临床医生提到这是由于临床医生的个性和价值观。临床医生之间的差异包括讨论所有治疗方案与仅讨论最佳治疗方案以及讨论益处和危害的程度。大多数患者的目标是接受治愈性治疗，无论后果如何，因为他们相信这可以延长他们的寿命。
由于很少观察到多学科小组会议提议的治疗和实际治疗的变化，这项研究强调了充分制定多学科小组会议提案的重要性.
The probability of undergoing treatment with curative intent according to the hospital of diagnosis varies for esophagogastric cancer in the Netherlands. Little is known about the factors contributing to this variation. This study aimed to improve the understanding of the differences between the multidisciplinary team meeting treatment proposal and the treatment that was actually carried out and to qualitatively investigate the differences in treatment decision-making after the multidisciplinary team meeting treatment proposal between hospitals.
To gain an in-depth understanding of treatment decision-making, quantitative data (i.e., multidisciplinary team meeting proposal and treatment that was carried out) were collected from the Netherlands Cancer Registry. Changes in the multidisciplinary team meeting proposal and applied treatment comprised changes in the type of treatment option (i.e., curative or palliative, or no change) and were calculated according to the multivariable multilevel probability of undergoing treatment with curative intent (low, middle, and high). Qualitative data were collected from eight hospitals, including observations of 26 outpatient clinic consultations, 30 in-depth interviews with clinicians, seven focus groups with clinicians, and three focus groups with patients. Clinicians and patients\' perspectives were assessed using thematic content analysis.
The multidisciplinary team meeting proposal and applied treatment were concordant in 97% of the cases. Clinicians\' implementation of treatment decision-making in clinical practice varied, which was mentioned by the clinicians to be due to the clinician\'s personality and values. Differences between clinicians consisted of discussing all treatment options versus only the best fitting treatment option and the extent of discussing the benefits and harms. Most patients aimed to undergo curative treatment regardless of the consequences, since they believed this could prolong their life.
Since changes in the multidisciplinary team meeting-proposed treatment and actual treatment were rarely observed, this study emphasizes the importance of an adequately formulated multidisciplinary team meeting proposal.
