The Impact of a Multidisciplinary Tumor Board (MDTB) in the Management of Colorectal Cancer (CRC)

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2025-01-10 DOI:10.1016/j.clcc.2025.01.002

Francesco Schietroma , Maria Bensi , Maria Alessandra Calegari , Carmelo Pozzo , Michele Basso , Giustina Valente , Giulia Caira , Giovanni Trovato , Alexia Spring , Viria Beccia , Anna Ceccarelli , Serena Perazzo , Laura Chiofalo , Brunella Barbaro , Giulia Tatulli , Sergio Alfieri , Davide De Sio , Laura Lorenzon , Roberto Persiani , Filippo Lococo , Lisa Salvatore

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引用次数: 0

Abstract

Background

The management of colorectal cancer (CRC) is a complex process. Defining the disease burden, assessing the radiological response and identifying the right time for surgery or other locoregional treatments are crucial factors which can require the involvement of a multidisciplinary tumor board (MDTB) comprising several specialists. This study investigates the impact of MDTB on management of CRC in our institution.

Methods

We retrospectively assessed all cases discussed by our MDTB between September 2019 and April 2023. In particular, we collected data concerning radiology, surgery and radiotherapy indication before and after MDTB meetings. The primary endpoint was the overall rate of discrepancy between pre- and post-discussion evaluations.

Results

Our analysis involved 1150 cases. Median age was 64 years (16-90), 629 patients (54.7%) were male and 915 (79.5%) had metastatic disease at the time of the relevant MDTB discussion. After the meetings, 325 treatment decisions were modified, producing an overall discrepancy rate of 28.3%. In particular: (1) of 648 cases discussed for radiological assessment, 156 decisions (24.1%) were altered after a central imaging review; (2) of 327 cases considered for surgical approach, treatment strategy changed in 118 (36.1%); and (3) of the 160 cases discussed regarding radiotherapy, the treatment strategy changed in 51 of them (31.9%).

Conclusions

Our analysis shows significant discrepancies between the radiology and locoregional evaluations from both before and after the MDTB meetings. Our results highlight that the discussions of a MDTB can considerably change the management of CRC, maximizing the treatment strategy.

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多学科肿瘤委员会（MDTB）在结直肠癌（CRC）管理中的影响。

背景：结直肠癌（CRC）的治疗是一个复杂的过程。确定疾病负担、评估放射反应和确定手术或其他局部治疗的合适时间是关键因素，可能需要由几位专家组成的多学科肿瘤委员会（MDTB）的参与。本研究探讨耐多药结核对我院结直肠癌管理的影响。方法：我们回顾性评估了2019年9月至2023年4月期间MDTB讨论的所有病例。特别是，我们收集了MDTB会议前后有关放射学、手术和放疗指征的数据。主要终点是讨论前后评估之间的总体差异率。结果：我们分析了1150例病例。中位年龄为64岁（16-90岁），629例（54.7%）为男性，915例（79.5%）在相关的MDTB讨论时已经转移。会议结束后，325项治疗决定被修改，总体差异率为28.3%。特别是：(1)在648例放射学评估病例中，156例（24.1%）在中央影像学检查后改变了决定；(2)在327例考虑手术入路的患者中，改变治疗策略的118例（36.1%）；(3)在讨论的160例放疗病例中，有51例（31.9%）改变了治疗策略。结论：我们的分析显示，在MDTB会议前后的放射学和局部区域评估之间存在显著差异。我们的研究结果强调，讨论耐多药结核可以显著改变结直肠癌的管理，最大限度地提高治疗策略。

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.