At the 9th Annual Meeting of the Chinese Medical Doctor Association’s Colorectal Oncology Committee, Dr. Guanghai Dai from Chinese PLA General Hospital delivered an in-depth presentation on the topic "The Value and Exploration of MDT in the Comprehensive Treatment of Colorectal Cancer." His talk covered the historical evolution of the MDT model, its proven clinical benefits, current challenges, and future directions, offering valuable insights and guidance for clinical practice. MDT Evolution: From Exploration to Precision Oncology
Multidisciplinary Team (MDT) treatment is a clinical model in which a fixed team of experts from multiple disciplines collaborates regularly to discuss specific organ- or system-based diseases, providing comprehensive diagnostic and treatment recommendations.
The application of MDT in oncology treatment has undergone multiple developmental phases, evolving from an experimental approach to a precise, individualized treatment strategy that has become an indispensable part of modern cancer care.
MDT originated in Europe and North America and was introduced into oncology treatment in the mid-to-late 20th century, though it initially remained a non-mainstream approach. By the late 20th and early 21st centuries, MDT entered a standardized development phase, gaining formal recognition in NCCN and ESMO guidelines as a standard treatment protocol for oncology management.
As medical advancements in precision medicine and immunotherapy accelerated, MDT evolved into an integrated, multidisciplinary treatment model, combining molecular diagnostics, advanced imaging, and targeted therapies. Over time, it became the gold standard in oncology care.
Entering the 21st century, MDT matured into a digital and globalized system. Electronic medical records, imaging transmission, and remote consultations have facilitated cross-border collaborations, enabling developing countries to mitigate disparities in healthcare resources through virtual MDT platforms. Additionally, AI-assisted tools such as imaging analysis and clinical decision-support systems have enhanced diagnostic accuracy and treatment efficiency.
Since the 2010s, MDT has transitioned into an era of precision and personalized medicine. The integration of genomics, liquid biopsy, and big data analytics has enabled tailored treatment strategies based on a patient’s molecular profile and biomarkers. The decision-making process within MDT has evolved from consensus-based discussions to precision-driven clinical pathways.
In recent years, MDT has expanded beyond oncology, proving its value in the management of chronic diseases and rare disorders. This demonstrates its broader applicability and underscores its growing significance in modern medicine.
Currently, MDT for colorectal cancer has achieved global recognition and is firmly established as a core treatment model. It is endorsed by NCCN, ESMO, and other international guidelines and has even been incorporated into national legislation in the UK to ensure standardized clinical implementation. In the United States, MDT principles are integrated into medical licensing exams, further emphasizing their importance in clinical education.
In China, MDT for colorectal cancer has significantly contributed to the widespread adoption of this approach nationwide. It remains one of the most widely applied and highly effective models in oncology, with multiple national guidelines and expert consensus reports continuously updated to refine its implementation.
Advancing Multidisciplinary Treatment (MDT) for Precision Therapy in Colorectal Cancer
Establishing a Model of Excellence: Chinese PLA General Hospital’s MDT Program
Since its establishment in September 2009, the Multidisciplinary Team (MDT) for Colorectal Cancer at Chinese PLA General Hospital has evolved into a national benchmark for comprehensive cancer care. The MDT program integrates over ten specialties, including medical oncology, surgical oncology, radiation oncology, interventional ultrasound, pathology, nuclear medicine, gastroenterology, traditional Chinese medicine, psychology, and nutrition. The team holds weekly multidisciplinary ward rounds, ensuring comprehensive and precise treatment for each patient.
In 2014, the MDT model was extended to outpatient services, optimizing patient access to care and significantly improving clinical efficiency. To date, Chinese PLA General Hospital’s colorectal cancer MDT has reviewed over 10,000 cases, benefiting a vast number of patients. Retrospective analyses confirm that MDT significantly improves both progression-free survival (PFS) and overall survival (OS). Among 149 stage IV colorectal cancer patients, median PFS increased from 10.0 months to 11.6 months (P = 0.007), and median OS improved from 28.5 months to 34.2 months (P = 0.478). Furthermore, 39.5% of patients initially deemed inoperable were converted to surgical candidates following MDT discussions. Of these, 22.1% underwent synchronous resection of the primary tumor and metastases, and 18.7% achieved R0 resection, demonstrating MDT’s substantial impact on treatment success.
Beyond its institutional success, Chinese PLA General Hospital’s MDT model has been widely disseminated both nationally and internationally. In 2011, China Central Television (CCTV) featured the MDT team, sparking national interest in the model. The program has since expanded to military hospitals, Beijing municipal hospitals, and institutions across China. Internationally, the MDT team has engaged in collaborations with the University of Liverpool and other global research institutions, marking a significant transition from domestic excellence to international recognition.
To further standardize MDT processes, the hospital has established comprehensive protocols and published multiple educational books and journals, helping both medical professionals and patients better understand the MDT approach. Data show that MDT discussions have led to changes in initial treatment plans for 20%–30% of patients, with an execution rate exceeding 80%, significantly enhancing treatment efficacy. Chinese PLA General Hospital Colorectal Cancer Academic Conference, now in its tenth edition, has become a highly influential forum for academic exchange, providing a valuable platform for knowledge sharing and professional development.
Since 2016, Dr. Guanghai Dai has chaired the Precision Medicine and Tumor MDT Professional Committee (PMOC) of the Chinese Research Hospital Association, fostering national MDT collaborations and exchanges. Through PMOC, regional MDT networks have been established, and multiple clinical casebooks on gastrointestinal tumors have been published, offering invaluable references for clinical practice.
A Realistic Perspective: Strengths and Limitations of MDT
MDT offers significant clinical and administrative advantages. Clinically, it improves patient prognosis, optimizes treatment planning, and enhances diagnostic accuracy. From a hospital management perspective, it reduces treatment delays, lowers healthcare costs, improves resource utilization, and enhances institutional efficiency. Moreover, MDT strengthens patient trust and plays a key role in advancing medical education and research.
Despite its strengths, MDT still faces several limitations in real-world application. One of the main challenges is the lack of substantive cross-disciplinary engagement, where some MDT discussions become formalities rather than meaningful exchanges. Another issue is low patient engagement, as many patients have limited understanding of their treatment plans, leading to communication gaps and insufficient attention to quality-of-life and psychological support. Resource inequality in non-specialist hospitals also presents a challenge, making MDT implementation difficult outside of major cancer centers. Scheduling conflicts and efficiency concerns further impact MDT operations, with limited meeting frequency, coordination difficulties, and time constraints reducing its overall effectiveness. Additionally, misconceptions about MDT, challenges in decision execution, and the limited availability of molecular diagnostics continue to hinder the full potential of the model.
Innovating the Future: Optimizing the MDT Model for Colorectal Cancer
To address these challenges, several key strategies can be implemented. Resource integration and process standardization will be essential for expanding MDT accessibility to lower-tier hospitals while ensuring equitable distribution of medical expertise. Optimizing MDT workflows by clearly defining the roles of each specialty and implementing uniform protocols will improve discussion efficiency and streamline decision-making.
Technology will play a crucial role in advancing MDT. Expanding the use of molecular diagnostics and next-generation sequencing (NGS) will refine precision medicine applications, allowing for more tailored treatment strategies. The integration of AI-powered decision support systems into tumor diagnostics and treatment planning will enhance diagnostic accuracy and improve surgical decision-making. Strengthening multidisciplinary data-sharing platforms will further optimize healthcare resource utilization and promote seamless collaboration among specialists.
Patient participation is another critical factor in improving MDT effectiveness. Enhancing patient education through accessible, comprehensive materials on MDT treatment pathways will ensure patients are more informed and engaged in their care. Providing psychological support programs and strengthening patient-clinician communication will also improve treatment adherence and overall satisfaction.
Policy support will be instrumental in facilitating MDT adoption nationwide. Expanding insurance coverage for MDT services will reduce financial barriers for patients, making multidisciplinary cancer care more accessible. Increasing government funding and incentives for MDT implementation will accelerate its integration into routine clinical practice. Additionally, developing specialized MDT training programs to cultivate highly skilled interdisciplinary teams will ensure a steady supply of experts capable of delivering high-quality care.
Moving forward, MDT committees will continue refining the model to improve efficiency and accessibility. Establishing expert consensus guidelines will help standardize MDT implementation across different hospitals, ensuring uniform quality and best practices. Efforts will also be directed toward expanding MDT services to lower-tier hospitals, conducting nationwide surveys on MDT implementation, and developing targeted strategies to overcome identified challenges.
Conclusion: The Future of MDT in Colorectal Cancer Treatment
MDT has demonstrated unparalleled advantages in the comprehensive treatment of colorectal cancer. By fostering multidisciplinary collaboration, it enhances diagnostic precision, improves treatment efficiency, and optimizes patient outcomes. However, successful MDT implementation requires overcoming existing barriers through better resource integration, technological innovation, increased patient involvement, and supportive policies.
Moving forward, the refinement and expansion of MDT will further advance precision oncology, delivering more effective, personalized treatment strategies for patients. With a collaborative, evidence-based approach, MDT will continue to reshape the landscape of colorectal cancer care, bringing higher standards of treatment and better outcomes to patients worldwide.
Expert Profile: Dr. Guanghai Dai
Affiliation: The General Hospital of the PLA
Position: Chief Physician, Professor, PhD in Oncology
- Doctoral Advisor at PLA Medical Academy and Nankai University
- Director of Medical Oncology, Oncology Department, The General Hospital of the PLA
- Consulting Expert for the Sixth Central Health Protection Committee and the Third Central Military Commission Health Protection Committee
- Recipient of the 2020 “National Distinguished Physician – Excellence in Innovation” Award
- Chair of the Precision Medicine and Tumor MDT Committee, Chinese Research Hospital Association
- Chair of the MDT Committee, Chinese Medical Doctor Association’s Colorectal Oncology Committee
- Vice Chair of the Colorectal Cancer Group, Chinese Society of Clinical Oncology (CSCO)
- Vice Chair of the Biliary Tract Tumor and Pancreatic Cancer Expert Committees, CSCO
- Standing Member of the Intelligent Medicine Committee
- Committee Member of the Gastric and Colorectal Cancer Committees
