Association of multidisciplinary team management with clinical outcomes in hepatobiliary and pancreatic malignancies: A systematic review and meta-analysis.

BACKGROUND

Multidisciplinary team (MDT) management is widely endorsed for complex hepatobiliary and pancreatic (HBP) malignancies. However, robust systematic evidence evaluating its survival benefits and heterogeneity across distinct anatomical sites remains limited.

METHODS

Our study systematically searched four databases from their inception through Dec 17, 2025, for studies comparing MDT versus non-MDT care in HBP malignancies. The primary outcome was overall survival or mortality risk. Secondary outcomes included the rates of neoadjuvant therapy administration and overall treatment receipt, as well as perioperative outcomes. To mitigate clinical heterogeneity, analyses were stratified into pancreatic/ampullary and hepatobiliary cohorts.

RESULTS

Our study included 23 studies comprising 70,294 patients. In the pancreatic and ampullary tumour cohort, MDT management was associated with a significantly reduced risk of mortality (HR 0.74 [95% CI 0.68-0.82]; I2 = 35.8%). Furthermore, MDT intervention significantly increased the rate of neoadjuvant therapy administration (RR 1.51 [1.48-1.58]; I2 = 0%) and decreased the risk of clinically relevant postoperative pancreatic fistula (CR-POPF ≥ grade B; RR 0.51 [0.31-0.84]; I2 = 0%). Similarly, in the hepatobiliary cohort, MDT management correlated with a significant reduction in mortality risk (HR 0.58 [0.41-0.82]; I2 = 95.3%). In sensitivity analyses, the exclusion of a single study reduced heterogeneity (I2 = 63.2%) while suggesting the protective trend persisted (HR 0.53 [0.43-0.65]). Descriptive analysis indicated that MDT evaluation modified diagnosis or treatment strategies in approximately 26% of cases.

CONCLUSION

These findings support the clinical value of routine MDT evaluation in optimising therapeutic strategies for complex HBP malignancies. Nevertheless, due to substantial inter-study variability and pathological differences, the overall survival benefit should be interpreted with caution.