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胸科多学科肿瘤委员会对癌症患者管理的影响:贝鲁特美国大学医疗中心的一项回顾性研究

Impact of thoracic multidisciplinary tumor boards on the management of patients with cancer: A retrospective study at the American university of Beirut medical center.

作者信息

Kreidieh Firas, Tfayli Arafat

机构信息

Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, 1755 Wyndale St, Houston, Texas 77030, USA.

Division of Hematology-Oncology, American University of Beirut Medical Center, Riad El Solh, Beirut 1107 2020, Beirut, Lebanon.

出版信息

Mol Clin Oncol. 2022 Dec 19;18(1):6. doi: 10.3892/mco.2022.2602. eCollection 2023 Jan.

Abstract

Multidisciplinary tumor boards (MDT) provide an opportunity for experts from different specialties and expertise to pool and complement each other's experience and inputs. Several factors impact the MDT discussions, including the meeting's structure, time management, and expert leadership. The process of MDT, their utilization, and efficacy need continuous assessment and improvement. A retrospective study was conducted to review the process of thoracic MDT, their plans of therapy, and changes in diagnosis and treatment plans for patients with cancer at the American University of Beirut Medical Center (AUBMC) over the period of one year. The primary outcome measure was the percentage of patients presented at the thoracic MDT who had a change in their treatment plan after the presentation. A total of 214 cases were scheduled for thoracic MDT during the study period. The majority, 132 (61.7%) did not have a treatment plan before presenting in the MDT. Of the 195 cases presented, only 43 (22.0%) did not have a change in their plan, while 88 (45.2%) of the cases presented had a change in their treatment plan. A total of 64 (32.8%) cases consisted of discussion of the diagnosis during MDT with either confirmation or modification of the patients' diagnosis. Of the 195 cases that were presented, the majority, 170 (87.2%), had their recommended treatment plan implemented after the MDT discussion. There was an association between the stage of cancer at the time of presentation and requesting additional tests (P=0.021), but there was no association between the stage of cancer and change in treatment plan (P=0.177) nor with implementation of recommendation (P=0.217). MDT are used to make upfront management decisions. In addition to considering change in management plans as an indicator of the benefit of MDT, it is suggested that making upfront multidisciplinary plans shall be considered an additional component of indicators of the benefit of MDT.

摘要

多学科肿瘤委员会(MDT)为来自不同专业和专长领域的专家提供了一个汇聚并互补彼此经验和意见的机会。有几个因素会影响MDT的讨论,包括会议结构、时间管理和专家领导。MDT的流程、其应用及效果需要持续评估和改进。进行了一项回顾性研究,以审视贝鲁特美国大学医疗中心(AUBMC)为期一年的胸部MDT流程、其治疗计划以及癌症患者诊断和治疗计划的变化。主要结局指标是在胸部MDT上汇报后治疗计划发生改变的患者百分比。在研究期间,共有214例病例被安排参加胸部MDT。其中大多数,即132例(61.7%)在参加MDT之前没有治疗计划。在汇报的195例病例中,只有43例(22.0%)的计划没有改变,而汇报的病例中有88例(45.2%)的治疗计划发生了改变。共有64例(32.8%)病例在MDT期间进行了诊断讨论,对患者的诊断进行了确认或修正。在汇报的195例病例中,大多数,即170例(87.2%)在MDT讨论后实施了推荐的治疗计划。汇报时癌症分期与要求进行额外检查之间存在关联(P = 0.021),但癌症分期与治疗计划的改变(P = 0.177)以及与推荐的实施(P = 0.217)之间均无关联。MDT用于做出前期管理决策。除了将管理计划的改变视为MDT益处的一个指标外,建议将制定前期多学科计划视为MDT益处指标的一个额外组成部分。

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