Effectiveness of multidisciplinary team collaboration in focal pancreatic lesion management: a systematic review

The diagnosis and management of focal pancreatic lesions is complex with diagnostic uncertainty and inconsistent guidelines. While multidisciplinary teams (MDTs) have emerged as the standard of care to navigate this challenge, a comprehensive synthesis of their impact is absent from literature. This systematic review aims to consolidate evidence on how formal MDT-led care influences diagnostic accuracy, treatment decisions and timelines, guideline compliance, and clinical outcomes for this diverse patient population.

This systematic review was conducted following the PRISMA guidelines and was registered on PROSPERO. We searched PubMed, Scopus, and CENTRAL through 14 April 2025 to identify studies evaluating the impact of MDTs on the management of focal pancreatic lesions. Three independent reviewers performed screening and data extraction, with conflicts resolved by a fourth reviewer.

Our systematic review included 20 studies encompassing 14,366 patients. MDT review led to a change in primary diagnosis in 17.6% to 37.9% of cases and altered clinical stage or resectability assessment in 18.7% to 31.5% of patients following expert re-evaluation of imaging and pathology. Consequently, the initial management plan was modified in 18% to 72% of cases. This consistently improved patient selection, with increased use of neoadjuvant therapy, higher rates of guideline-concordant care and clinical trial enrollment, and more frequent referral to palliative care, significantly reducing non-therapeutic laparotomies. While MDT management was associated with a significantly higher likelihood of achieving a complete (R0) surgical resection (OR 5.47), its impact on overall survival was inconsistent across the reviewed literature.

This systematic review provides substantial evidence that MDT-led care fundamentally improves the management of focal pancreatic lesions. MDT implementation consistently enhanced diagnostic accuracy, optimized treatment planning, and increased guideline-concordant care, leading to improved surgical outcomes. While the evidence is largely retrospective, these benefits strongly support the MDT as an indispensable standard of care. Future research should focus on optimizing the MDT model’s structure, quality, and cost-effectiveness to maximize patient benefit globally.

PROSPERO (CRD420251142032)