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多学科团队(MDT)讨论改善转移性肾细胞癌患者的总生存结局。

Multidisciplinary Team (MDT) Discussion Improves Overall Survival Outcomes for Metastatic Renal Cell Carcinoma Patients.

作者信息

Zeng Yuhao, Zhu Sha, Wang Zilin, Chen Junru, Dai Jindong, Liu Zhenhua, Sun Guangxi, Liang Jiayu, Zhang Xingming, Wang Zhipeng, Zhao Jinge, Ni Yuchao, Yang Jiyu, Wang Minghao, Wei Qiang, Li Xiang, Chen Ni, Li Zhiping, Wang Xin, Shen Yali, Yao Jin, Huang Rui, Liu Jiyan, Cai Diming, Zeng Hao, Shen Pengfei

机构信息

Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

出版信息

J Multidiscip Healthc. 2023 Feb 23;16:503-513. doi: 10.2147/JMDH.S393457. eCollection 2023.

Abstract

PURPOSE

Multidisciplinary team (MDT) discussion is a widely used model to manage patients diagnosed with cancer. However, there has been no direct evidence to prove its effect on the prognosis of metastatic renal cell carcinoma (mRCC) patients, so this study explored the impact of MDT discussion on mRCC patient survival.

METHODS

The clinical data of 269 mRCC patients were retrospectively collected from 2012 to 2021. The cases were grouped into the MDT and non-MDT groups, then subgroup analysis was performed according to different histology types, as well as exploring the role of MDT in patients who have undergone multiple-line therapy. Overall survival (OS) and progression free survival (PFS) were set as the study endpoint.

RESULTS

Approximately half (48.0%, 129/269) of the patients were in the MDT group, with univariable survival analyses showing these patients had remarkably longer median OS (MDT group: 73.7 months; non-MDT group: 33.2 months, hazard ratio (HR): 0.423 (0.288, 0.622), p<0.001) and longer median PFS (MDT group: 16.9 months, non-MDT group: 12.7 months, HR: 0.722 (0.542, 0.962), p=0.026). Furthermore, MDT management resulted in longer survival for both ccRCC and non-ccRCC subgroups. Patients in the MDT group were more likely to receive multi-line therapy (MDT group: 79/129, 61.2% vs non-MDT group: 56/140, 40.0%, p<0.001), and within this patient group, MDT management still resulted in longer OS (MDT group: 94.0 months; non-MDT group: 43.5 months, p=0.009).

CONCLUSION

MDT is associated with prolonged overall survival in mRCC independent of histology, ensuring that patients receive better management and precise treatment.

摘要

目的

多学科团队(MDT)讨论是一种广泛应用于管理癌症确诊患者的模式。然而,尚无直接证据证明其对转移性肾细胞癌(mRCC)患者预后的影响,因此本研究探讨了MDT讨论对mRCC患者生存的影响。

方法

回顾性收集2012年至2021年269例mRCC患者的临床资料。将病例分为MDT组和非MDT组,然后根据不同组织学类型进行亚组分析,并探讨MDT在接受多线治疗患者中的作用。将总生存期(OS)和无进展生存期(PFS)设定为研究终点。

结果

约一半(48.0%,129/269)的患者在MDT组,单变量生存分析显示这些患者的中位OS显著更长(MDT组:73.7个月;非MDT组:33.2个月,风险比(HR):0.423(0.288,0.622),p<0.001),中位PFS也更长(MDT组:16.9个月,非MDT组:12.7个月,HR:0.722(0.542,0.962),p=0.026)。此外,MDT管理使ccRCC和非ccRCC亚组的生存期均延长。MDT组患者更有可能接受多线治疗(MDT组:79/129,61.2% vs非MDT组:56/140,40.0%,p<0.001),在该患者群体中,MDT管理仍使OS更长(MDT组:94.0个月;非MDT组:43.5个月,p=0.009)。

结论

MDT与mRCC患者总生存期延长相关,与组织学无关,可确保患者得到更好的管理和精准治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872d/9971520/437ecd10e30d/JMDH-16-503-g0001.jpg

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