Rob G. Stirling, Amelia Harrison, Joanna Huang, Vera Lee, John Taverner, Hayley Barnes
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Outcomes included time to diagnosis and treatment, histological confirmation, receipt of treatments, clinical trial participation, survival and quality of life. Risk of bias was assessed using the ROBINS-I (Risk of Bias in Non-randomised Studies – of Interventions) tool.</p>\n</sec>\n<sec><st>Results:</st>\n<p>2947 citations were identified, and 20 studies were included. MDM presentation significantly increased histological confirmation of diagnosis (OR 3.01, 95% CI 2.30–3.95; p<0.00001) and availability of clinical staging (OR 2.55, 95% CI 1.43–4.56; p=0.002). MDM presentation significantly increased likelihood of receipt of surgery (OR 2.01, 95% CI 1.29–3.12; p=0.002) and reduced the likelihood of receiving no active treatment (OR 0.32, 95% CI 0.21–0.50; p=0.01). MDM presentation was protective of both 1-year survival (OR 3.23, 95% CI 2.85–3.68; p<0.00001) and overall survival (hazard ratio 0.63, 95% CI 0.55–0.72; p<0.00001).</p>\n</sec>\n<sec><st>Discussion:</st>\n<p>MDM presentation was associated with increased likelihood of histological confirmation of diagnosis, documentation of clinical staging and receipt of surgery. Overall and 1-year survival was better in those presented to an MDM, although there was some clinical heterogeneity in participants and interventions delivered. 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引用次数: 0
摘要
背景：多学科参与多学科会议（MDM）并在会上发言可提高肺癌诊断、分期和治疗的效果。我们进行了一项系统综述和荟萃分析，以探索接触多学科会议对临床影响的文献证据。方法：我们注册了一项研究方案（PROSPERO 标识符 CRD42021258069）。纳入的随机对照试验和观察性队列研究包括非小细胞肺癌成人患者，与未接受MDM审查的患者相比，他们接受了MDM审查。于 2021 年 5 月 31 日检索了 MEDLINE、CENTRAL、Embase 和 ClinicalTrials.gov。由两名审稿人对研究进行筛选和提取。研究结果包括诊断和治疗时间、组织学证实、接受治疗情况、临床试验参与情况、存活率和生活质量。采用ROBINS-I（非随机干预研究中的偏倚风险）工具评估偏倚风险。结果：共发现2947条引文，纳入20项研究。MDM的出现大大提高了组织学确诊率（OR 3.01，95% CI 2.30–3.95；p<0.00001）和临床分期率（OR 2.55，95% CI 1.43–4.56；p=0.002）。出现 MDM 会明显增加接受手术的可能性（OR 2.01，95% CI 1.29–3.12；p=0.002），降低不接受积极治疗的可能性（OR 0.32，95% CI 0.21–0.50；p=0.01）。讨论：MDM与组织学确诊、临床分期记录和接受手术的可能性增加有关。在MDM就诊的患者总生存率和1年生存率较高，但参与者和所采取的干预措施存在一定的临床异质性。需要进一步开展研究，以确定向 MDM 呈报的最佳方法，并解决呈报障碍。
Multidisciplinary meeting review in nonsmall cell lung cancer: a systematic review and meta-analysis
Background:
Lung cancer diagnosis, staging and treatment may be enhanced by multidisciplinary participation and presentation in multidisciplinary meetings (MDM). We performed a systematic review and meta-analysis to explore literature evidence of clinical impacts of MDM exposure.
Methods:
A study protocol was registered (PROSPERO identifier CRD42021258069). Randomised controlled trials and observational cohort studies including adults with nonsmall cell lung cancer and who underwent MDM review, compared to no MDM, were included. MEDLINE, CENTRAL, Embase and ClinicalTrials.gov were searched on 31 May 2021. Studies were screened and extracted by two reviewers. Outcomes included time to diagnosis and treatment, histological confirmation, receipt of treatments, clinical trial participation, survival and quality of life. Risk of bias was assessed using the ROBINS-I (Risk of Bias in Non-randomised Studies – of Interventions) tool.
Results:
2947 citations were identified, and 20 studies were included. MDM presentation significantly increased histological confirmation of diagnosis (OR 3.01, 95% CI 2.30–3.95; p<0.00001) and availability of clinical staging (OR 2.55, 95% CI 1.43–4.56; p=0.002). MDM presentation significantly increased likelihood of receipt of surgery (OR 2.01, 95% CI 1.29–3.12; p=0.002) and reduced the likelihood of receiving no active treatment (OR 0.32, 95% CI 0.21–0.50; p=0.01). MDM presentation was protective of both 1-year survival (OR 3.23, 95% CI 2.85–3.68; p<0.00001) and overall survival (hazard ratio 0.63, 95% CI 0.55–0.72; p<0.00001).
Discussion:
MDM presentation was associated with increased likelihood of histological confirmation of diagnosis, documentation of clinical staging and receipt of surgery. Overall and 1-year survival was better in those presented to an MDM, although there was some clinical heterogeneity in participants and interventions delivered. Further research is required to determine the optimal method of MDM presentation, and address barriers to presentation.
期刊介绍：
The European Respiratory Review (ERR) is an open-access journal published by the European Respiratory Society (ERS), serving as a vital resource for respiratory professionals by delivering updates on medicine, science, and surgery in the field. ERR features state-of-the-art review articles, editorials, correspondence, and summaries of recent research findings and studies covering a wide range of topics including COPD, asthma, pulmonary hypertension, interstitial lung disease, lung cancer, tuberculosis, and pulmonary infections. Articles are published continuously and compiled into quarterly issues within a single annual volume.
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