Multidisciplinary Team Intervention: Catalysts for Changing Prognosis in Advanced Breast Cancer.

IF 2.2 4区医学 Q3 ONCOLOGY

Journal of Breast Cancer Pub Date : 2025-05-16 DOI:10.4048/jbc.2025.0001

Jun-Sheng Zheng, Hui Fu, Zhao Bi, Zhi-Qiang Shi, Jinming Yu, Peng-Fei Qiu, Yong-Sheng Wang

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引用次数: 0

Abstract

Purpose: Multidisciplinary team (MDT) discussions are standard in cancer care; however, their effect on advanced breast cancer (ABC) prognosis is not well-documented. This study examined the impact of MDT intervention on ABC patient survival.

Methods: A retrospective analysis of ABC patients diagnosed 2018 to 2021 was conducted by dividing them into MDT and non-MDT groups. Kaplan-Meier analysis was used to compare progression-free survival (PFS) and overall survival (OS) between the groups. Prognostic factors were evaluated using multivariate Cox regression analysis with subgroup analysis and 1:1 propensity score matching (PSM) to control for confounders.

Results: Total 707 patients were included, with 72.8% (515/707) underwent MDT intervention. After a median follow-up of 43.73 months (interquartile range, 34.87-55.67 months), MDT intervention improved the median PFS (12.00 vs. 8.00 months; hazard ratio [HR], 0.75 [95% confidence interval {CI}, 0.63-0.89]; p = 0.001) and median OS (55.67 vs. 40.07 months; HR, 0.77 [95% CI, 0.61-0.97]; p = 0.030). Multivariate Cox analysis showed MDT as an independent factor for disease progression control (HR, 0.82 [95% CI, 0.68-0.98]; p = 0.041), but not for OS (HR, 0.88 [95% CI, 0.69-1.12]; p = 0.286). Subgroup analysis indicated that MDT benefited patients aged ≤ 39 years, those with disease status (de novo metastatic breast cancer), post-menopausal status, T4 stage, N3 stage, G3, visceral metastasis, > one organ metastasis and first-line systemic treatment, regardless of PFS or OS. After PSM, 172 matched patients were in the cohort. MDT still significantly controlled disease progression (12.00 vs. 8.00; HR, 0.74 [95% CI, 0.59-0.93]; p = 0.009) but did not significantly impact the OS (49.00 vs. 39.00; HR, 0.80 [95% CI, 0.59-1.08]; p = 0.121).

Conclusion: MDT effectively controlled the disease progression and improved OS in specific patient subgroups.

查看原文本刊更多论文

多学科团队干预：改变晚期乳腺癌预后的催化剂。

目的：多学科小组（MDT）讨论是癌症治疗的标准；然而，它们对晚期乳腺癌（ABC）预后的影响并没有很好的文献记载。本研究探讨了MDT干预对ABC患者生存的影响。方法：回顾性分析2018 ~ 2021年诊断的ABC患者，将其分为MDT组和非MDT组。Kaplan-Meier分析比较各组间无进展生存期（PFS）和总生存期（OS）。预后因素采用多变量Cox回归分析、亚组分析和1:1倾向评分匹配（PSM）来控制混杂因素。结果：共纳入707例患者，72.8%（515/707）接受了MDT干预。中位随访43.73个月（四分位数间距34.87-55.67个月）后，MDT干预改善了中位PFS (12.00 vs. 8.00个月；风险比[HR]， 0.75[95%可信区间{CI}， 0.63-0.89]；p = 0.001)和中位OS (55.67 vs. 40.07个月；Hr, 0.77 [95% ci, 0.61-0.97]；P = 0.030)。多因素Cox分析显示MDT是疾病进展控制的独立因素(HR, 0.82 [95% CI, 0.68-0.98]；p = 0.041)，但OS无统计学意义(HR, 0.88 [95% CI, 0.69-1.12]；P = 0.286)。亚组分析显示，MDT使年龄≤39岁、疾病状态（新发转移性乳腺癌）、绝经后状态、T4期、N3期、G3期、内脏转移、>一器官转移和一线全身治疗的患者受益，无论PFS或OS如何。PSM后，172名匹配的患者进入队列。MDT仍能显著控制疾病进展(12.00 vs. 8.00；Hr, 0.74 [95% ci, 0.59-0.93]；p = 0.009)，但对OS无显著影响(49.00 vs. 39.00；Hr, 0.80 [95% ci, 0.59-1.08]；P = 0.121)。结论：MDT可有效控制疾病进展，改善特定亚组患者的OS。

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

Journal of Breast Cancer 医学-肿瘤学

CiteScore

3.80

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Breast Cancer (abbreviated as ''J Breast Cancer'') is the official journal of the Korean Breast Cancer Society, which is issued quarterly in the last day of March, June, September, and December each year since 1998. All the contents of the Journal is available online at the official journal website (http://ejbc.kr) under open access policy. The journal aims to provide a forum for the academic communication between medical doctors, basic science researchers, and health care professionals to be interested in breast cancer. To get this aim, we publish original investigations, review articles, brief communications including case reports, editorial opinions on the topics of importance to breast cancer, and welcome new research findings and epidemiological studies, especially when they contain a regional data to grab the international reader''s interest. Although the journal is mainly dealing with the issues of breast cancer, rare cases among benign breast diseases or evidence-based scientifically written articles providing useful information for clinical practice can be published as well.