Mangone Lucia, Marinelli Francesco, Bisceglia Isabella, Braghiroli Maria Barbara, Mastrofilippo Valentina, Pezzarossi Annamaria, Morabito Fortunato, Aguzzoli Lorenzo, Mandato Vincenzo Dario
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Unit of Obstetrics and Gynaecology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Healthcare (Basel). 2023 Dec 27;12(1):64. doi: 10.3390/healthcare12010064.
This study aimed to assess the impact of a multidisciplinary team (MDT) approach on outcomes with endometrial cancer (EC) patients, utilizing 2013-2020 data from the Reggio Emilia Cancer Registry. Recurrence rate, treatments, and outcome indicators were compared between the MDT (319 cases) and non-MDT (324 cases) groups. Among 643 cases, 52.4% were over 65 years old, 98% had microscopic confirmation, and 73% were in stage I. Surgery was performed in 89%, with 41% receiving adjuvant therapies. Recurrence rates (10%) were similar between the two groups, but MDT patients who were older and predominantly in stage I exhibited 79% recurrence within one year (21% in the non-MDT group). Disease-free survival (DFS) showed no significant difference [HR 1.1; 95% CI 0.7-1.6], while differences in overall survival (OS) were notable [HR 1.5; 95% CI 1.0-2.4]. The 5-year OS rates were 87% and 79% in the MDT and non-MDT groups. Comparing the 2013-2015 to 2016-2020 study periods, a shift towards caring for older women, more advanced-stage patients, and those residing outside the metropolitan area, along with a greater number of relapsed cases (from 16% to 76%), were accounted for. These findings underscore the impact of an MDT on EC outcomes, highlighting the evolving patient demographics over time.
本研究旨在利用雷焦艾米利亚癌症登记处2013 - 2020年的数据,评估多学科团队(MDT)方法对子宫内膜癌(EC)患者治疗结果的影响。比较了MDT组(319例)和非MDT组(324例)的复发率、治疗情况和结果指标。在643例病例中,52.4%的患者年龄超过65岁,98%的病例有显微镜确诊,73%处于I期。89%的患者接受了手术,41%接受了辅助治疗。两组的复发率(10%)相似,但年龄较大且主要处于I期的MDT患者在一年内的复发率为79%(非MDT组为21%)。无病生存期(DFS)无显著差异[风险比(HR)1.1;95%置信区间(CI)0.7 - 1.6],而总生存期(OS)存在显著差异[HR 1.5;95% CI 1.0 - 2.4]。MDT组和非MDT组的5年总生存率分别为87%和79%。比较2013 - 2015年和2016 - 2020年的研究期,发现护理对象向老年女性、病情更晚期患者以及大都市地区以外居住的患者转变,同时复发病例数量增加(从16%增至76%)。这些发现强调了MDT对EC治疗结果的影响,突出了患者人口统计学特征随时间的演变。