Barts Health NHS Trust, London, UK.
University College London Hospitals, London, UK.
Br J Cancer. 2021 Jan;124(2):368-374. doi: 10.1038/s41416-020-01075-1. Epub 2020 Sep 29.
The germ cell supranetwork multidisciplinary team (SMDT) for the Anglian Network covers a population of 7.5 million.
We reviewed 10 years of SMDT discussion and categorised them into five domains ((1) overall outcome, (2) chemotherapy regimens-untreated disease and salvage therapy, (3) radiology, (4) pathology and (5) complex cases) to assess the impact of the SMDT.
A total of 2892 new cases were reviewed. In the first 5 years, patients with good prognosis disease had poorer survival in low-volume vs high-volume centres (87.8 vs 95.3, p = 0.02), but the difference was no longer significant in the last 5 years (93.3 vs 95.1, p = 0.30). Radiology review of 3206 scans led to rejection of the diagnosis of progression in 26 cases and a further 10 cases were down-staged. There were 790 pathology reviews by two specialised uropathologists, which lead to changes in 75 cases. F-fluorodeoxyglucose (FDG) PET-CT was undertaken during this time period but did not help to predict who would have viable cancer. A total of 26 patients with significant mental health issues who were unable to give informed consent were discussed.
SMDT working has led to an improvement in outcomes and refining of treatment in patients with germ cell tumours.
安格尔网络的生殖细胞超网络多学科团队（SMDT）覆盖了 750 万人口。
我们回顾了 10 年的 SMDT 讨论，并将其分为五个领域（1）总体结果，（2）未经治疗的疾病和挽救治疗的化疗方案，（3）放射学，（4）病理学和（5）复杂病例），以评估 SMDT 的影响。
共回顾了 2892 例新病例。在前 5 年，低容量中心与高容量中心相比，预后良好疾病患者的生存率较低（87.8%比 95.3%，p=0.02），但在后 5 年差异不再显著（93.3%比 95.1%，p=0.30）。对 3206 次扫描进行放射学复查，26 例被拒绝诊断进展，另有 10 例被降级。有 790 次病理复查由两位专门的泌尿科病理学家进行，其中 75 例发生变化。在此期间进行了 F-氟脱氧葡萄糖（FDG）PET-CT，但并未帮助预测哪些患者会有存活的癌症。共有 26 名有严重心理健康问题的患者无法知情同意，对其进行了讨论。
SMDT 的工作导致生殖细胞肿瘤患者的结局改善和治疗方案的细化。
