Multidisciplinary Team Meeting Significantly Enhances Disease-Free Survival in Stage II-III Rectal Cancer

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2024-12-28 DOI:10.1016/j.clcc.2024.12.006

Wenheng Jiang , Xue Dou , Nan Zhang , Jinming Yu , Lei Zhao , Jinbo Yue

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Abstract

Background

Multidisciplinary team (MDT) meetings have been increasingly recognized for enhancing cancer treatment outcomes; however, their specific impact on stage II-III rectal cancer remains to be fully elucidated.

Materials and Methods

This retrospective cohort study investigated the influence of MDT meeting on disease-free survival (DFS) and overall survival (OS) in patients with stage II-III rectal cancer. Propensity score matching (PSM) was used to minimize selection bias. Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare DFS and OS between groups.

Results

A total of 502 patients were included, with 176 whose cases were discussed in MDT meetings and 326 who did not undergo MDT discussions. After PSM, 173 patients were matched in each group. The MDT group exhibited a significantly improved DFS compared to the non-MDT group, both before PSM (HR = 0.618, P = .037) and after PSM (HR = 0.545, P = .012). Subgroup analysis indicated notable benefits of MDT discussions for patients with T3 to 4 tumors, low to mid tumor locations, and node-positive tumors. While there was a trend towards improved OS in the MDT group, this did not reach statistical significance. More MDT group patients received MRI staging and neoadjuvant therapy compared to non-MDT group.

Conclusions

Discussion in MDT meetings is associated with improved DFS in stage II-III rectal cancer, particularly among patients with locally advanced, low to mid rectal cancer. These findings underscore the importance of incorporating MDT discussions into routine clinical practice to optimize outcomes for rectal cancer patients.

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多学科团队会议显著提高II-III期直肠癌的无病生存率。

背景：多学科团队（MDT）会议在提高癌症治疗效果方面越来越得到认可；然而，它们对II-III期直肠癌的具体影响仍有待充分阐明。材料与方法：本回顾性队列研究探讨了MDT治疗对II-III期直肠癌患者无病生存期（DFS）和总生存期（OS）的影响。倾向评分匹配（PSM）用于最小化选择偏差。采用Kaplan-Meier生存分析和Cox比例风险模型比较各组间的DFS和OS。结果：共纳入502例患者，其中176例在MDT会议上讨论，326例未进行MDT讨论。经PSM后，每组配对173例。与非MDT组相比，MDT组在PSM前（HR = 0.618, P = 0.037）和PSM后（HR = 0.545, P = 0.012）均表现出显著改善的DFS。亚组分析显示，对于T3至4期肿瘤、低至中位肿瘤和淋巴结阳性肿瘤患者，MDT讨论有显著的益处。虽然MDT组有改善OS的趋势，但没有达到统计学意义。与非MDT组相比，MDT组接受MRI分期和新辅助治疗的患者较多。结论：MDT会议上的讨论与II-III期直肠癌的DFS改善有关，特别是在局部晚期、低至中期直肠癌患者中。这些发现强调了将MDT讨论纳入常规临床实践以优化直肠癌患者预后的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.