Department of Endocrinology & Diabetes Mellitus, St Vincent's University Hospital-University College Dublin, 4 Elm Park, Dublin 4, Ireland,
Endocrine. 2013 Oct;44(2):504-9. doi: 10.1007/s12020-013-9910-5. Epub 2013 Mar 8.
According to the international guidelines, a multidisciplinary approach is currently advised for the optimal care of patients with a gastroenteropancreatic neuroendocrine tumor (GEP NET). In our institution (tertiary care center), a systematic multidisciplinary approach was established in May 2007. In this study, we have aimed to assess the initial impact of establishing a systematic multidisciplinary approach to the management of GEP NET patients. We have collected and compared the biochemical, imaging, and pathological data and the therapeutic strategies in GEP NET patients diagnosed, treated, or followed-up from January 1993 to April 2007 versus GEP NET patients attending our institution after the multidisciplinary approach starting, from May 2007 to October 2008. Data of 91 patients before and 42 patients after the establishment of the multidisciplinary approach (total: 133 consecutive GEP NET patients) have been finally collected and analyzed. Before the establishment of the multidisciplinary approach, a lack of consistency in the biochemical, imaging, and pathological findings before treatment initiation as well as during follow-up of GEP NET patients was identified. These inconsistencies have been reduced by the systematic multidisciplinary approach. In addition, the therapeutic management of GEP NET patients has been altered by the multidisciplinary approach and became more consistent with recommended guidelines. We think that a systematic multidisciplinary approach significantly impacts on GEP NET patient care and should be established in all centers dealing with these tumors.
根据国际指南，目前建议采用多学科方法为胃胰肠神经内分泌肿瘤（GEP NET）患者提供最佳治疗。在我们的机构（三级保健中心），于 2007 年 5 月建立了系统的多学科方法。在这项研究中，我们旨在评估建立系统的多学科方法来管理 GEP NET 患者的初始影响。我们收集和比较了 1993 年 1 月至 2007 年 4 月诊断、治疗或随访的 GEP NET 患者的生化、影像和病理数据以及治疗策略，与 2007 年 5 月多学科方法开始后至 2008 年 10 月在我们机构就诊的 GEP NET 患者进行了比较。最终收集和分析了 91 例多学科方法建立前和 42 例建立后（共 133 例连续 GEP NET 患者）的数据。在多学科方法建立之前，发现 GEP NET 患者在开始治疗前以及在随访期间的生化、影像和病理发现缺乏一致性。这些不一致性通过系统的多学科方法得到了减少。此外，多学科方法改变了 GEP NET 患者的治疗管理，使其更符合推荐的指南。我们认为，系统的多学科方法显著影响 GEP NET 患者的治疗，应在所有处理这些肿瘤的中心建立。
