Cervical cancer is the most common malignant tumor in gynecology. Each year, more than half a million women are diagnosed with cervical cancer, and the disease results in over 3,00,000 deaths worldwide. More than 85% of new cases and approximately 90% of deaths occur in developing countries (1, 2). Whether treatment should be surgery or radiotherapy is closely related to cervical cancer staging, which is discussed and decided by gynecologists, radiologists, imaging physicians, and pathologists (3, 4). Extensive hysterectomy combined with complete pelvic lymph node dissection for cervical cancer requires the assistance of anesthesiology, colorectal, vascular, urological, reproductive, pathology, nutrition, and intensive care units as well as nursing teams (5–7). Radiotherapy for cervical cancer involves oncologic radiotherapy, oncologic chemotherapy, gynecologic oncology, pathology, nutrition, and nursing teams (8, 9). Cervical cancer treatment requires multidisciplinary communication and collaboration to develop individualized and high-quality precise treatment plans to improve the diagnosis and treatment of cervical cancer and improve the survival and quality of life of these patients (10, 11).

Multidisciplinary collaboration for cervical cancer treatment needs to integrate the clinical knowledge, skills, and experience of all relevant departments in a hospital or relevant multidisciplinary team (MDT) models in higher-level hospitals according to a patient’s physical and psychological conditions, pathological type, clinical stage, and the developmental tendency for high-quality diagnosis and a precise individualized treatment plan based on evidence-based medicine to achieve the best treatment outcome that is economical and can maximize the survival rate and quality of life (12, 13). For complex and difficult cases, the MDT approach should be used to recommend individualized and precise treatment plans on the basis of a patient’s wishes and affordability, which are guided by the latest research and guidelines, and one should master the appropriate timing of treatment and prevention of complications (14, 15). A few studies on MDTs for cervical cancer are available. Thus, in this study, we evaluated the role of an MDT for cervical cancer in clinical practice by analyzing the clinical data of MDT consultation, decision content of MDT discussion, implementation, and follow-up results of patients with cervical cancer.

Patients undergoing monotherapy require multiple referrals or consultations, which can be time-consuming and result in poor adherence to treatment. A treatment model via an MDT integrates the advantages of various related disciplines to develop an individualized, high-quality, and precise treatment plan, which plays an important role in improving the survival rate, quality of life, and prognosis of patients (10–15). In this study, we evaluated the role of an MDT in clinical practice for cervical cancer by analyzing the clinical data of MDT consultation, decision content of MDT discussion, implementation, and follow-up results of patients with cervical cancer.

All 392 patients were unvaccinated. Among them, 65.82% had a KPS score of ≥ 80 at admission, 359 had a first episode, including 284 in stages IA–IIA2, 75 in stages IIB–IVB, and 33 had a relapse, with a minimum of 2 days and a maximum of 2.5 months from diagnosis to treatment. We analyzed the clinical data of 416 MDT cases of cervical cancer and compared the outcomes of 364 cases with implemented decisions and the 52 cases without implemented decisions. We found that patients with implemented decisions were significantly better than those without implemented decisions in terms of diagnosis time, surgery efficiency, standardized radiotherapy, standardized chemotherapy, and other treatments. Moreover, the expected efficiency of full implementation was higher than that of partial implementation (93.99% vs. 72.84%), with a statistically significant difference (P < 0.05). Of note, 16.59% of patients with internal iliac vein injury, bowel injury, bladder injury, ureteral injury, and intraoperative placement of ureteral stents were joint surgeries between two specialties with adequate preoperative evaluation. Urology was the specialty with the highest cooperation with cervical cancer surgery. The decisions of all 416 cases involved diagnosis plus treatment, and treatment decisions included neoadjuvant chemotherapy plus surgery, surgery, radiotherapy, concurrent chemoradiotherapy, and other treatments. Other treatments included chemotherapy, chemotherapy plus targeted therapy, chemotherapy plus immunotherapy, and targeted plus immunotherapy. All postoperative outcomes of surgical patients were discussed by gynecologic oncologists, pathologists, and radiotherapists on the basis of the postoperative treatment plan, and observation, radiotherapy, or concurrent radiotherapy was recommended. Furthermore, symptomatic treatments, such as nutrition and psychological support, in MDT consultation can alleviate the symptoms of the patients, reduce their discomfort, and improve their quality of life.

Maturation and close collaboration of MDT for cervical cancer requires a long-term process (16). Decisions made by the MDT may not be accurate, and even after maturation, the team members can change, which can result in poor collaboration. Moreover, the MDT of one center may not be able to make an individualized treatment plan in the best interest of the patient during difficult cases because of its platform and learning. Therefore, they may often require the assistance of the MDT for cervical cancer in a higher, larger medical center to discuss the condition of the patient via a video conference by two different MDT to create an accurate individualized treatment plan (17–20). This study has certain limitations. No clinical control study was performed and no comparison with previous cases was made to confirm the effect of MDT on the long-term prognosis of patients with cervical cancer. No life treatment survey was conducted to compare the effect of MDT on the quality of life. MDT for cervical cancer can significantly improve the immediate treatment outcome, but the effect on long-term prognosis, such as prolonging survival time and improving quality of life, needs further clinical observation. Therefore, more clinical trials should be conducted for active exploration (21, 22).

For the treatment of malignant tumors, a single discipline cannot fulfill the needs of the diagnosis and treatment of patients, and a simple subspecialty treatment system cannot provide comprehensive diagnosis and treatment advice to patients. Owing to the different levels of understanding and starting points of each specialist, they may give different or even opposite treatment opinions to patients on the basis of their professional point of view for the same disease. At the same time, clinical disciplines are gradually differentiating and refining, making it difficult for the discipline to keep abreast of the progress of other disciplines (17, 18). However, MDT is a face-to-face discussion and exchange of conditions of patients with malignant tumors through multidisciplinary meetings held at regular intervals. Thus, MDT can maximize the academic and professional advantages of multiple disciplines and make the best-individualized treatment plan that is most suitable for the patients on the basis of the treatment principles and clinical guidelines that are widely accepted (19, 20). MDT is gradually recognized by most countries after decades of development. Currently, several NCCN guidelines stipulate that all patients with diagnosed malignancies must undergo relevant MDT consultations before undergoing treatment (23, 24). The advantages of MDT are reflected in many aspects of the clinical consultation process such as interdepartmental cooperation, equal participation of patients and families, high-quality patient condition discussion, integration of relevant multidisciplinary, and education of young physicians. The MDT can provide better treatment for patients and improve their prognosis (25–27).

Accurate diagnoses and staging of tumors are important components of MDT for cervical cancer, and preoperative staging is determining whether the tumor should be treated with surgery, radiotherapy, or concurrent radiotherapy, and if surgery is selected, then the timing, surgical approach, and scope of surgery should also be determined (1–4). Postoperative staging can guide the way of postoperative adjuvant therapy such as radiotherapy, chemotherapy, or concurrent radiotherapy (28). Patients with advanced tumors can have PD-L1 mutation, the detection of which can guide different treatments of cervical cancer such as targeted treatment or immunization to determine the survival prognosis of patients and other conditions (29–35). If pregnant patients with cervical cancer choose to terminate their pregnancy, then the appropriate time to terminate the pregnancy and a reasonable and individualized treatment plan should be selected. If they choose to continue the pregnancy, then the safety of the fetus should be ensured, the prognosis of the mother should not be affected, and the effect of the treatment on the mother and fetus should be considered. For young patients, especially patients with cervical cancer, the preservation of reproductive functions is difficult during clinical diagnosis and treatment, and MDT can reflect the principle of individualized treatment while standardizing treatment to preserve the fertility of the patients while ensuring the therapeutic effect (36–39).

MDT is an inevitable trend in the development of tumor treatment. Moreover, it is also the development direction of cervical cancer treatment. MDT is patient-centered; therefore, instead of weighing the different opinions of physicians in each relevant department, multidisciplinary experts can work together to evaluate, discuss, and inform patients of the best diagnosis and treatment plan to achieve an integrated treatment for cervical cancer, which can simplify the medical consultation process, decrease clinical treatment time, improve treatment efficiency, save time and economic costs, and obtain a satisfactory medical experience (25–27, 40, 41). By discussing and arguing through interactive cooperation for treating patients, physicians can share the treatment strategy and clinical experience of top experts in various fields, update their professional knowledge, expand their treatment ideas, broaden their professional horizons, exchange the latest information, decrease the risk of errors, promote teamwork and disciplinary integration, cultivate new treatment ideas and techniques, create scientific research sparks, perform more relevant clinical research and basic research, and improve job satisfaction. Moreover, it can reduce interdepartmental referral rates, optimize and share resources, expand the influence of specialties, and improve the overall strength of hospitals (42, 43).

The execution of MDT decisions is correlated with age; the younger the patients, the higher the execution efficiency. The patients who achieved MDT expectations through all implementation and partial implementation were correlated with age. The patients who achieved MDT expectations through all non-implementation did not correlate with age. The MDT plays a crucial role in clinical practice aspects, such as clinical staging, treatment plans, and whole treatment management of cervical cancer patients, which makes the treatment of cervical cancer more standardized, precise, and individualized. The MDT can significantly improve the recent treatment effect by improving long-term prognoses such as the survival time and quality of life of patients with cervical cancer. However, MDT requires further clinical observation and active exploration.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The present study was approved by the Ethical Committee of Ganzhou Cancer Hospital (2023002). The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.

Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article.

JH completed most of the experiments, and XZ, HC, RL, and XW assisted in completing the experiments. YY, AC, DL, and CL completed data collection and statistics. JH and YP designed and supervised the completion of this experiment, and JH wrote this article. All authors contributed to the article and approved the submitted version.