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一场专门的多学科会议对消化道浅表性癌症管理的影响。

Impact of a dedicated multidisciplinary meeting on the management of superficial cancers of the digestive tract.

作者信息

Dermine Solène, Barret Maximilien, Prieux Caroline, Ribière Sophie, Leblanc Sarah, Dhooge Marion, Brezault Catherine, Abitbol Vered, Terris Benoit, Beuvon Frédéric, Rouquette Alexandre, Dousset Bertrand, Gaujoux Sébastien, Soyer Philippe, Dohan Anthony, Bibault Jean-Emmanuel, Coriat Romain, Prat Frédéric, Chaussade Stanislas

机构信息

Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.

Paris-Descartes University, Paris, France.

出版信息

Endosc Int Open. 2018 Dec;6(12):E1470-E1476. doi: 10.1055/a-0658-1350. Epub 2018 Dec 12.

Abstract

The recent development of endoscopic resection for superficial gastrointestinal cancers could justify the need for a dedicated oncological multidisciplinary meeting (MDM). The aim of our study was to evaluate the impact of the dedicated MDM on the management of superficial cancers of the digestive tract.  A dedicated MDM was developed at our tertiary referral center. A retrospective review of the MDM conclusions for all patients referred from March 2015 to March 2017 was performed. Outcomes measurements were the outcomes of endoscopic resection, and the concordance rate between the MDM recommendations, European Society of Gastrointestinal Endoscopy (ESGE) guidelines, and final patient management.  In total, 153 patients with a median age of 69 years were included. Half of the patients had major comorbidities. The mean lesion size was 25 mm, and R0 and curative resection rate were 73.9 % and 56.9 %, respectively. Forty-three patients had an indication for surgery after endoscopic resection. The concordance rate between ESGE guidelines and MDM recommendation was 92.2 %, and 12 patients did not receive the treatment recommended due to comorbidities.  A MDM dedicated to superficial tumors helped tailor the ESGE guidelines to each patient in order to avoid unnecessary surgery.

摘要

近期,针对浅表性胃肠道癌的内镜切除术发展迅速,这使得有必要召开专门的肿瘤多学科会诊(MDM)。我们研究的目的是评估专门的MDM对消化道浅表性癌症治疗的影响。

我们的三级转诊中心设立了专门的MDM。对2015年3月至2017年3月期间转诊的所有患者的MDM结论进行了回顾性分析。观察指标为内镜切除的结果,以及MDM建议、欧洲胃肠内镜学会(ESGE)指南与最终患者治疗方案之间的符合率。

总共纳入了153例患者,中位年龄为69岁。一半的患者有严重的合并症。平均病变大小为25毫米,R0切除率和根治性切除率分别为73.9%和56.9%。43例患者在内镜切除术后有手术指征。ESGE指南与MDM建议之间的符合率为92.2%,12例患者因合并症未接受推荐的治疗。

专门针对浅表肿瘤的MDM有助于根据每位患者的情况调整ESGE指南,以避免不必要的手术。

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