Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy; CRMPG (Advanced Pancreatic Research Center), Rome, Italy; Università Cattolica del Sacro Cuore di Roma, Rome, Italy.
Università Cattolica del Sacro Cuore di Roma, Rome, Italy; Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.
ESMO Open. 2021 Feb;6(1):100010. doi: 10.1016/j.esmoop.2020.100010. Epub 2020 Dec 14.
The implementation of multidisciplinary tumor board (MDTB) meetings significantly ameliorated the management of oncological diseases. However, few evidences are currently present on their impact on pancreatic cancer (PC) management. The aim of this study was to evaluate the impact of the MDTB on PC diagnosis, resectability and tumor response to oncological treatment compared with indications before discussion.
All patients with a suspected or proven diagnosis of PC presented at the MDTB from 2017 to 2019 were included in the study. Changes of diagnosis, resectability and tumor response to oncological/radiation treatment between pre- and post-MDTB discussion were analyzed.
A total of 438 cases were included in the study: 249 (56.8%) were presented as new diagnoses, 148 (33.8%) for resectability assessment and 41 (9.4%) for tumor response evaluation to oncological treatment. MDTB discussion led to a change in diagnosis in 54/249 cases (21.7%), with a consequent treatment strategy variation in 36 cases (14.5%). Change in resectability was documented in 44/148 cases (29.7%), with the highest discrepancy for borderline lesions. The treatment strategy was thus modified in 27 patients (18.2%). The MDTB brought a modification in the tumor response assessment in 6/41 cases (14.6%), with a consequent protocol modification in four (9.8%) cases.
MDTB discussion significantly impacts on PC management, especially in high-volume centers, with consistent variations in terms of diagnosis, resectability and tumor response assessment compared with indications before discussion.
多学科肿瘤委员会（MDTB）会议的实施显著改善了肿瘤疾病的管理。然而，目前关于其对胰腺癌（PC）管理影响的证据很少。本研究旨在评估 MDTB 对 PC 诊断、可切除性以及肿瘤对肿瘤治疗反应的影响，与讨论前的指征相比。
所有在 MDTB 就诊的疑似或确诊 PC 患者均被纳入本研究。分析 MDTB 讨论前后诊断、可切除性和肿瘤对肿瘤/放疗治疗反应的变化。
本研究共纳入 438 例患者：249 例（56.8%）为新诊断，148 例（33.8%）为可切除性评估，41 例（9.4%）为肿瘤对肿瘤治疗的反应评估。MDTB 讨论导致 54/249 例（21.7%）诊断发生变化，其中 36 例（14.5%）导致治疗策略发生变化。44/148 例（29.7%）记录到可切除性发生变化，边界病变差异最大。因此，27 例患者（18.2%）的治疗策略发生了改变。MDTB 在 6/41 例（14.6%）肿瘤反应评估中带来了变化，其中 4 例（9.8%）患者因此改变了方案。
MDTB 讨论对 PC 管理有显著影响，特别是在大容量中心，与讨论前的指征相比，在诊断、可切除性和肿瘤反应评估方面存在一致的变化。
