Perspectives and challenges of multidisciplinary collaboration in the treatment of metastatic spinal disease: Insights from an international survey

Abstract

Abstract: BackgroundAdvances in systemic therapies, radiotherapy, and surgery have made the management of metastatic spinal disease (MSD) more complex, increasing the need for multidisciplinary collaboration. This study aims to explore physicians’ perspectives on multidisciplinary collaboration and to identify challenges in delivering multidisciplinary care for patients with MSD. Methods: A cross-sectional, global, internet-based survey was distributed among medical oncologists, radiation oncologists, orthopedic surgeons, and neurosurgeons involved in the management of MSD. Questions focused on the effectiveness of current multidisciplinary collaboration, outcomes of multidisciplinary collaboration, and barriers to providing multidisciplinary care. Results: A total of 120 physicians completed the survey: 26 (22%) medical oncologists, 34 (28%) radiation oncologists, 31 (26%) orthopedic surgeons, and 29 (24%) neurosurgeons. Across all four specialties, approximately 75% considered current collaboration among medical oncologists, radiation oncologists, and spine surgeons effective. In total, 49% of respondents observed cases in which preventable complications occurred due to a perceived lack of multidisciplinary collaboration, and 69% reported observing cases where a lack of multidisciplinary collaboration resulted in the selection of suboptimal treatment strategies. Overall, respondents reported 162 challenges in delivering multidisciplinary care for patients with MSD, most commonly citing limited regional coordination between hospitals (28%) and insufficient collaboration among specialties (18%). Conclusions: Although most respondents viewed current multidisciplinary collaboration as effective, many reported observing cases where a lack of collaboration led to preventable complications or suboptimal care. These findings highlight the importance of strengthening multidisciplinary collaboration and enhancing regional coordination to improve outcomes for patients with MSD.