Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Asia Pac J Clin Oncol. 2024 Oct;20(5):634-642. doi: 10.1111/ajco.13972. Epub 2023 Jun 8.
To evaluate the effect of multidisciplinary treatment (MDT) on the survival outcomes of Chinese lung cancer patients.
Data from a Chinese tertiary cancer hospital of lung cancer patients were collected and divided into two groups (MDT+/-) according to whether the patients had received an MDT. The survival analysis was performed after propensity score matching (PSM).
Before PSM, more patients in the MDT+ group had documented information on clinical characteristics and showed more unfavorable clinical characteristics than patients in the MDT- group. After PSM, there was no imbalance in the first-line treatment strategies between the two groups. When the patients were analyzed separately, for patients in the MDT- group, age at diagnosis, Eastern Cooperative Oncology Group (ECOG) score, stage, smoking history, and epidermal growth factor receptor (EGFR) gene status were all significant factors for survival (p < 0.05). For patients in the MDT+ group, only age at diagnosis, stage, and comorbidities were significant factors for survival (p < 0.05). Moreover, age at diagnosis, ECOG score, stage, EGFR gene status, and MDT were all significant factors for survival for all patients (p < 0.001). The results indicate that MDT was a significant prognostic factor independent of clinical characteristics (HR: 2.095, 95% CI: 1.568-2.800, p < 0.001), with a significantly improved median survival (58.0 vs. 29.0 months, p < 0.001).
Based on PSM, MDT itself did have a real favorable prognostic significance for Chinese lung cancer patients in the study.
评估多学科治疗（MDT）对中国肺癌患者生存结局的影响。
收集一家中国三级肿瘤医院肺癌患者的数据，并根据患者是否接受 MDT 将其分为 MDT+/-两组。采用倾向评分匹配（PSM）后进行生存分析。
在 PSM 之前，MDT+组的患者有更多记录的临床特征信息，且表现出更多不利的临床特征。在 PSM 之后，两组之间的一线治疗策略没有不平衡。当分别分析患者时，对于 MDT-组的患者，诊断时的年龄、东部合作肿瘤学组（ECOG）评分、分期、吸烟史和表皮生长因子受体（EGFR）基因状态均是生存的显著因素（p<0.05）。对于 MDT+组的患者，只有诊断时的年龄、分期和合并症是生存的显著因素（p<0.05）。此外，诊断时的年龄、ECOG 评分、分期、EGFR 基因状态和 MDT 对所有患者的生存均是显著因素（p<0.001）。结果表明，MDT 是独立于临床特征的显著预后因素（HR：2.095，95%CI：1.568-2.800，p<0.001），中位生存时间明显延长（58.0 与 29.0 个月，p<0.001）。
基于 PSM，MDT 本身确实对研究中的中国肺癌患者具有真实的有利预后意义。
