Mangone Lucia, Marinelli Francesco, Bisceglia Isabella, Braghiroli Maria Barbara, Banzi Maria, Damato Angela, Iori Veronica, Pinto Carmine, Cerullo Loredana, Pellegri Carlotta, Zizzo Maurizio, Morabito Fortunato, Neri Antonino, Giorgi Rossi Paolo
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Cancers (Basel). 2024 Jun 28;16(13):2390. doi: 10.3390/cancers16132390.
Colorectal cancer emerged as the third most prevalent malignancy worldwide, affecting nearly 2 million individuals in the year 2020. This study elucidates the pivotal role of a multidisciplinary team (MDT) in influencing the prognosis, as measured by relative survival rates, depending upon the stage and age. Cases recorded in an Italian Cancer Registry between 2017 and 2018 were included. Relative survival was reported at 1 and 3 years after diagnosis comparing MDT vs. no-MDT approaches. During the study period, 605 CRCs were recorded while 361 (59.7%) were taken care of by an MDT. Compared to no-MDT, MDT patients were younger with earlier stages and received more surgery. One year after diagnosis, survival was 78.7% (90% in MDT vs. 62% in no-MDT); stratifying by stage, in the MDT group there was no survival advantage for stage I (97.2% vs. 89.9%) and II (96.8% vs. 89.4%), but an advantage was observed for stage III (86.4% vs. 56.9%) and stage IV (63.7% vs. 27.4%). Similar values were observed at 3 years where a marked advantage was observed for stages III (69.9% vs. 35.1%) and IV (29.2% vs. 5.1%). The univariable analysis confirmed an excess risk in the no-MDT group (HR 2.6; 95% CI 2.0-3.3), also confirmed in the multivariable regression analysis (HR 2.0; 95% CI 1.5-2.5). Despite the increase in the number of MDT patients in 2018 (from 50% to 69%), this does not correspond to an improvement in outcome.
结直肠癌成为全球第三大常见恶性肿瘤，2020年影响了近200万人。本研究阐明了多学科团队（MDT）在根据分期和年龄通过相对生存率衡量影响预后方面的关键作用。纳入了2017年至2018年意大利癌症登记处记录的病例。报告了诊断后1年和3年MDT与非MDT方法相比的相对生存率。在研究期间，记录了605例结直肠癌病例，其中361例（59.7%）由MDT进行治疗。与非MDT相比，MDT治疗的患者更年轻，分期更早，接受手术的比例更高。诊断后1年，生存率为78.7%（MDT组为90%，非MDT组为62%）；按分期分层，在MDT组中，I期（97.2%对89.9%）和II期（96.8%对89.4%）没有生存优势，但III期（86.4%对56.9%）和IV期（63.7%对27.4%）有优势。在3年时观察到类似的值，其中III期（69.9%对35.1%）和IV期（29.2%对5.1%）有明显优势。单变量分析证实非MDT组存在额外风险（HR 2.6；95% CI 2.0 - 3.3），多变量回归分析也证实了这一点（HR 2.0；95% CI 1.5 - 2.5）。尽管2018年MDT治疗的患者数量有所增加（从50%增至69%），但这并未带来结局的改善。
