多学科肿瘤委员会在结直肠癌肝转移患者管理中的应用：847例患者的单中心回顾
Multidisciplinary Tumor Board in the Management of Patients with Colorectal Liver Metastases: A Single-Center Review of 847 Patients.
作者信息
Milana Flavio, Famularo Simone, Luberto Antonio, Rimassa Lorenza, Scorsetti Marta, Comito Tiziana, Pressiani Tiziana, Franzese Ciro, Poretti Dario, Di Tommaso Luca, Personeni Nicola, Rodari Marcello, Pedicini Vittorio, Donadon Matteo, Torzilli Guido
机构信息
Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy.
Department of Hepatobiliary and General Surgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy.
出版信息
Cancers (Basel). 2022 Aug 16;14(16):3952. doi: 10.3390/cancers14163952.
There is still debate over how reviewing oncological histories and addressing appropriate therapies in multidisciplinary team (MDT) discussions may affect patients’ overall survival (OS). The aim of this study was to describe MDT outcomes for a single cancer center’s patients affected by colorectal liver metastases (CRLMs). From 2010 to 2020, a total of 847 patients with CRLMs were discussed at our weekly MDT meeting. Patients’ characteristics and MDT decisions were analyzed in two groups: patients receiving systemic therapy (ST) versus patients receiving locoregional treatment (LRT). Propensity-score matching (PSM) was run to reduce the risk of selection bias. The median time from MDT indication to treatment was 27 (IQR 13−51) days. The median OS was 30 (95%CI = 27−34) months. After PSM, OS for patients undergoing LRT was 51 (95%CI = 36−64) months compared with 15 (95%CI = 13−20) months for ST patients (p < 0.0001). In this large retrospective study, the MDT discussions were useful in providing the patients with all available locoregional options.
在多学科团队（MDT）讨论中，回顾肿瘤病史并确定合适的治疗方法如何影响患者的总生存期（OS），目前仍存在争议。本研究的目的是描述一家癌症中心受结直肠癌肝转移（CRLMs）影响患者的MDT治疗结果。2010年至2020年，共有847例CRLMs患者在我们每周的MDT会议上进行了讨论。对患者的特征和MDT决策进行了两组分析：接受全身治疗（ST）的患者与接受局部区域治疗（LRT）的患者。进行倾向评分匹配（PSM）以降低选择偏倚的风险。从MDT指示到治疗的中位时间为27（IQR 13 - 51）天。中位OS为30（95%CI = 27 - 34）个月。PSM后，接受LRT的患者的OS为51（95%CI = 36 - 64）个月，而ST患者为15（95%CI = 13 - 20）个月（p < 0.0001）。在这项大型回顾性研究中，MDT讨论有助于为患者提供所有可用的局部区域治疗选择。
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