Saeteng Somcharoen, Chewaskulyong Busyamas, Charoentum Chaiyut, Lertprasertsuke Nirush, Euathrongchit Juntima, Tajarernmuang Pattraporn, Klunklin Pitchayaponne, Siwachat Sophon, Kongkarnka Sarawut, Wannasopha Yutthaphan, Suksombooncharoen Thatthan, Ketpueak Thanika, Tantraworasin Apichat
Clinical Surgical Research Center, Chiang Mai University, Chiang Mai 50200, Thailand.
Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
J Clin Med. 2024 Sep 5;13(17):5276. doi: 10.3390/jcm13175276.
: The prolonged time to reach investigation and management decisions in non-small cell lung cancer (NSCLC) patients can negatively impact long-term outcomes. This retrospective cohort study aims to assess the impact of a multidisciplinary team conference (MDT) on NSCLC care quality and outcomes. : This retrospective study included resectable NSCLC patients who underwent pulmonary resection at Chiang Mai University Hospital, Thailand, from 1 January 2009 to 31 December 2021. Patients were divided into two groups: non-MDT and MDT groups, based on the initiation of MDT on 1 March 2018. The study compared overall survival, disease-free survival, and waiting times for investigation and surgery between the two groups. The effect of MDT on these outcomes was analyzed using multivariable analysis with inverse-probability weighting propensity scores. : The study included 859 patients, with 583 in the non-MDT group and 276 in the MDT group. MDT groups had a higher proportion of stage I and II NSCLC patients undergoing pulmonary resection (78.6% vs. 59.69%, < 0.001). In multivariable analysis, patients in the MDT group had a significantly higher likelihood of longer survival compared to the non-MDT group (adjusted HR 0.23, 95% CI 0.09-0.55). Median waiting times for bronchoscopy (3 days vs. 12 days, = 0.012), pathologic report (7 days vs. 13 days, < 0.001), and surgery scheduling (18 days vs. 25 days, = 0.001) were significantly shorter in the MDT group. : An MDT has a survival benefit in NSCLC care and improves waiting times for investigation and treatment steps. Further studies are needed to validate these results.
非小细胞肺癌（NSCLC）患者在达成检查和治疗决策方面的时间延长会对长期预后产生负面影响。这项回顾性队列研究旨在评估多学科团队会议（MDT）对NSCLC护理质量和预后的影响。 ：这项回顾性研究纳入了2009年1月1日至2021年12月31日期间在泰国清迈大学医院接受肺切除术的可切除NSCLC患者。根据2018年3月1日MDT的启动情况，患者被分为两组：非MDT组和MDT组。该研究比较了两组患者的总生存期、无病生存期以及检查和手术的等待时间。使用具有逆概率加权倾向评分的多变量分析来分析MDT对这些预后的影响。 ：该研究纳入了859例患者，其中非MDT组583例，MDT组276例。MDT组中接受肺切除术的I期和II期NSCLC患者比例更高（78.6%对59.69%，<0.001）。在多变量分析中，与非MDT组相比，MDT组患者存活时间更长的可能性显著更高（调整后HR 0.23，95%CI 0.09 - 0.55）。MDT组支气管镜检查的中位等待时间（3天对12天，=0.012）、病理报告（7天对13天，<0.001）和手术安排（18天对25天，=0.001）明显更短。 ：MDT在NSCLC护理中具有生存获益，并改善了检查和治疗步骤的等待时间。需要进一步研究来验证这些结果。
