Structured Lung Cancer MDT Form

Browser-based research and education prototype for structured lung cancer MDT preparation, registry extraction, cTNM support, CCI calculation, itemised G8 screening, and completeness checks.

Prototype version 3.1. Research and education use only.

Privacy: This form runs entirely in your browser. No data is sent anywhere. Refreshing the page clears all fields. Do not share screenshots, printouts, or copied summaries containing identifiable patient information outside approved clinical systems.

Use: This checklist is a structured preparation and teaching tool for lung cancer MDT discussion. It does not replace national guidelines, local protocols, clinical judgment, or formal MDT documentation systems.

Patient

Age

Sex

Smoking status

Pack-years

Years since quitting if former smoker

Weight (kg)

Height (cm)

BMI auto-calculated

Functional status

WHO / ECOG performance status G8 score geriatric screening, 0 to 17 Performance / exercise capacity stair test, CPET, six-minute walk, 500 m flat walk, oxygen need

Imaging

Imaging overview

Enter dates for each imaging module. Use the same date format throughout. Avoid personal identifiers in free text if the summary is copied outside the clinical record.

Baseline diagnostic CT

CT date

CT region

Contrast

Primary lesion and thoracic findings Nodal findings on CT Extrathoracic / adrenal / liver / bone findings on CT

PET-CT

PET-CT date

PET status

Comparison with CT

PET-CT findings Sites needing confirmation

Brain imaging

Brain imaging date

Brain imaging modality

Contrast

Brain imaging findings

Previous and comparison imaging

Previous CT date

Previous PET-CT date

Other comparison date

Growth / stability / volume doubling time Prior imaging relevance

Radiology review for MDT

Radiology review date

Radiologist present at MDT?

Imaging complete for staging?

Radiology MDT question Radiology conclusion / missing imaging

Other imaging studies method + date + main findings

Pathology

Diagnostic sample site, method, date if useful Histology / cytology adenocarcinoma: include growth pattern if reported, e.g. micropapillary Largest tumour diameter (cm) Staging investigations and findings e.g. EBUS: 4R benign, 4L insufficient, 11R adenocarcinoma metastasis c1-TNM before MDT and basis

Biomarkers

PD-L1 (TPS, %) numeric only, not positive / high / low EGFR if positive: subtype e.g. exon 19 del, L858R, exon 20 ins ALK fusion IHC / FISH / NGS

ROS1 fusion

BRAF esp. V600E

KRAS esp. G12C

MET exon 14 skipping, amplification

RET fusions

ERBB2 / HER2 mutation / amplification, esp. exon 20 ins

NTRK1 to 3 fusions Other NGS findings

MDT recommendation

MDT participants radiologist, thoracic surgeon, pulmonologist, pathologist, oncologist, nurse, palliative care… Further investigations recommended c2-TNM after MDT Treatment intent Surgery or bronchoscopic procedures including stents if relevant Oncological drug therapy include eligibility for clinical trials Radiotherapy chemoradiation / definitive / palliative, target and fractionation if known Symptom care and supportive care

Structured Lung Cancer MDT Form

Meeting

Patient

Comorbidity and medication

Functional status

Lung function

Imaging

Pathology

Biomarkers

Patient preference

MDT recommendation