What an MDT discussion is meant to produce
A multidisciplinary team discussion brings together clinicians from different specialties — for liver cancer these may include hepatobiliary surgery, medical oncology, interventional radiology, radiotherapy and pathology — so that one plan reflects more than a single clinic's view. The output you should expect is a written summary: what the team understood from your records, which options it considers relevant, which it does not, and what further information it needs before a decision.
That summary is the practical document you can compare across hospitals. It is not the same as a consultation with one doctor, and it is not the same as hospital acceptance. A team can recommend a direction while the hospital still has to confirm whether it can admit you, schedule the relevant procedure and meet the clinical requirements of your case.
Because the format varies, the first question is administrative: does this hospital actually run a multidisciplinary discussion for liver cancer, how often, who attends, and will you receive a written record? If the answer is unclear, ask before you plan travel. Do not assume that every tertiary hospital in China offers the same meeting structure.
Tumour questions the discussion should answer
The team needs to describe the disease precisely. Ask what the imaging shows about the number of lesions, their size, their location within the liver, and whether there is evidence of involvement outside the liver. Ask whether the imaging is considered adequate or whether the team wants additional views or a repeat study.
Ask how the disease is being staged and which staging system is being used. Staging language differs between clinicians, and a plan built on an unclear stage is difficult to compare with another opinion. If pathology is available, ask whether the team accepts the existing report or wants the slides reviewed.
Ask what the team considers the goal of treatment in your situation — for example, whether it is discussing potentially curative approaches, controlling the disease, or relieving symptoms. This is not a request for a promise. It is a request for the reasoning behind the recommendation, so you can understand why one option is being proposed over another.
Liver function and background liver disease
Liver cancer decisions depend heavily on how well the liver is working and on any underlying liver disease. The discussion should state which liver-function results were reviewed, how recent they are, and whether the team considers them sufficient. Ask whether the team wants additional blood tests, imaging of the liver's blood vessels, or an assessment of portal hypertension before it can recommend a treatment.
If you have a history of viral hepatitis, cirrhosis, fatty liver disease or alcohol-related liver disease, say so clearly and provide the relevant records. These details change what is safe and what is realistic, and a team that does not have them may give a plan that does not fit your situation.
Ask what the team expects in terms of liver reserve during and after any proposed treatment. You are not asking the team to predict the future; you are asking which measurements informed its view and which uncertainties remain.
Previous local treatment and what it changes
Prior treatment matters, and it changes the questions rather than only the paperwork. If you have had surgery, ablation, embolisation, radiotherapy or systemic therapy, the team needs dates, techniques, treated areas and the response. Ask whether the team has enough detail to judge whether a previously treated area can be treated again, and whether it needs the original procedure reports rather than only the discharge summary.
Ask how the team interprets any recurrence or residual disease after earlier treatment. The answer should distinguish between a new lesion, incomplete treatment of an old one, and disease that has progressed despite treatment. Each leads to different questions. A new lesion in a different part of the liver raises the issue of whether the liver can tolerate further local treatment. Incomplete treatment of a known area raises the question of whether the same approach should be repeated, adjusted, or replaced. Progression despite treatment raises the question of whether the treatment was working at all and what should change.
If you have received systemic therapy, provide the drug names, the number of cycles and the reason it stopped. Ask whether the team considers that treatment still relevant to the current decision, and whether it would want to see the original imaging rather than a written description. A written summary that says only that a treatment was given, without the imaging and response assessment, leaves the team guessing about what actually happened.
Ask whether the team needs the original imaging from before and after each previous treatment, not only the most recent scan. Comparing the two is how a team judges whether a treated area responded, stayed stable or progressed. If you do not have the earlier images, say so and ask whether the team can work with what you have or whether it wants you to obtain them.
Ask how previous treatment affects the options the team is now considering. A liver that has already received one or more local treatments may have less reserve for another, and the team should say which measurements inform that view. Ask whether the team considers any prior treatment a reason to avoid a particular approach, and what it would need to reconsider that position.
If you have had more than one previous treatment, ask the team to list them in order with the response to each. A sequence of treatments tells a different story than a single line in a discharge summary, and the team's recommendation should reflect that sequence. Ask whether any gap in the record changes what the team can conclude, and what document would fill it.
Finally, ask what the team would do differently if a previous treatment had not been given. This question separates treatments that are still available from those that have already been used, and it shows you which parts of the plan depend on your history rather than on the current imaging alone.
Options, alternatives and what the team cannot yet decide
A useful discussion does not only name a preferred option. It explains why the alternatives were set aside, what would change the recommendation, and what remains uncertain. Ask the team to state which options it considers technically possible, which it considers unsuitable and on what grounds, and what information would move a case from one category to another.
Where radiotherapy is among the options, the technique and schedule depend on the individual treatment plan, so ask how the team would decide between approaches and what planning steps would be required. A recommendation to proceed is not the same as a completed plan; consultation, planning and delivery are separate stages, and the hospital must confirm what it can provide.
Ask directly what the team cannot yet answer. A written list of open questions is more useful than a confident summary that hides gaps. If the team says it needs a specific scan, a pathology review or a specialist assessment, note exactly what is missing and who is expected to obtain it.
Records to send and questions to ask before travel
Send a short summary first: diagnosis, date of diagnosis, main treatments to date, current symptoms, current medications and your single most important question. Then provide the supporting documents the hospital requests. Typical items include recent cross-sectional imaging on disc or via a secure link, pathology reports, blood tests including liver function, endoscopy or procedure reports, and discharge summaries from previous admissions.
Ask the hospital or coordinating team to confirm in writing what it has received, what it still needs, and whether a multidisciplinary discussion is part of the pathway for your case. Ask who will communicate the outcome to you, in what language, and whether you will receive a document you can share with your doctors at home.
Do not delay urgent local care while an overseas enquiry is in progress. If your symptoms worsen, seek assessment where you are. An initial enquiry through ChinaSpecialistCare is free and non-clinical: it checks the available records and your main question, identifies missing information and suggests a relevant next step. It does not confirm hospital acceptance or treatment availability.
- Confirm whether the hospital runs a liver cancer multidisciplinary discussion and how often.
- Ask which specialties attend and whether a written summary is provided.
- Ask what imaging, pathology and liver-function records the team needs.
- Ask what the team considers the goal of treatment and why alternatives were set aside.
- Ask what remains undecided and what would change the recommendation.
- Ask who will communicate the outcome and in what language.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.