Wanis Kerollos N, Pineda-Solis Karen, Tun-Abraham Mauro E, Yeoman Jake, Welch Stephen, Vogt Kelly, Van Koughnett Julie Ann M, Ott Michael, Hernandez-Alejandro Roberto
Department of Surgery, Western University, London Health Sciences Centre, London, Canada.
Schulich School of Medicine and Dentistry, Western University, London, Canada.
Hepatobiliary Surg Nutr. 2017 Jun;6(3):162-169. doi: 10.21037/hbsn.2017.01.01.
While no evidence exists to support mandatory multidisciplinary case conference (MCC) review for patients with synchronous colorectal cancer and liver metastases, this unique population may benefit greatly from multidisciplinary discussion.
We retrospectively identified patients who underwent liver resection with curative intent for colorectal liver metastases (CRLM) at a tertiary center between January 2008 and June 2015. The characteristics of patients discussed at a weekly regional MCC were examined, and the effect of MCC review on treatment approach was assessed.
Sixty-six patients underwent elective surgery for synchronous colorectal cancer and liver metastases during the study period. Twenty-nine patients (44%) were presented at a MCC. Presentation was associated with greater likelihood of undergoing simultaneous or liver-first resection (P≤0.0001), with no difference in the extent of liver resection or location of primary tumor between the groups. A greater proportion of patients received chemotherapy and/or radiation following MCC discussion, without statistical significance.
The treatment approach for patients with synchronous colorectal cancer and liver metastases may be significantly altered based on MCC review. Multidisciplinary discussion is advocated in order to facilitate equal access to individualized care.
虽然尚无证据支持对同时性结直肠癌和肝转移患者进行强制性多学科病例讨论（MCC）审查，但这一特殊人群可能会从多学科讨论中受益匪浅。
我们回顾性确定了2008年1月至2015年6月期间在一家三级中心接受旨在治愈结直肠癌肝转移（CRLM）的肝切除术的患者。检查了在每周一次的地区性MCC上讨论的患者特征，并评估了MCC审查对治疗方法的影响。
在研究期间，66例患者接受了同时性结直肠癌和肝转移的择期手术。29例患者（44%）在MCC上进行了讨论。讨论与同时或先进行肝切除的可能性更大相关（P≤0.0001），两组之间肝切除范围或原发肿瘤位置无差异。在MCC讨论后，接受化疗和/或放疗的患者比例更高，但无统计学意义。
基于MCC审查，同时性结直肠癌和肝转移患者的治疗方法可能会发生显著改变。提倡进行多学科讨论，以促进平等获得个性化护理。
