Mangone Lucia, Zizzo Maurizio, Nardecchia Melissa, Marinelli Francesco, Bisceglia Isabella, Braghiroli Maria Barbara, Banzi Maria Chiara, Damato Angela, Cerullo Loredana, Pellegri Carlotta, Morabito Fortunato, Neri Antonino, Fabozzi Massimiliano, Pinto Carmine, Giorgi Rossi Paolo
Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Unit of Surgical Oncology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy.
Biology (Basel). 2024 Nov 15;13(11):928. doi: 10.3390/biology13110928.
This study aimed to assess whether multidisciplinary team (MDT) management improves outcomes in patients with stage I-III colorectal cancer (CRC) compared to non-MDT care. This study included 460 CRC patients diagnosed from 2017 to 2018 in a northern Italian province, of whom 300 (65%) were managed by MDT. MDT patients were younger, more frequently had rectal cancers, were diagnosed at earlier stages, and were more likely to undergo surgery and chemotherapy. Disease-free survival (DFS) and overall survival (OS) were significantly better in the MDT group. The recurrence rate was 8.5%, with no significant differences between MDT and non-MDT patients, although MDT patients exhibited lower recurrence rates for early-stage tumors. A multivariable analysis showed that DFS and OS were adversely affected by older age, advanced stage, and lack of MDT management. Kaplan-Meier estimates demonstrated a 3-year DFS of 78% in the MDT group versus 65% in the non-MDT group, as well as an OS of 83% versus 69%, respectively. The MDT approach was associated with improved treatment adherence and better management of recurrences. While limited by a small sample size, this population-based study highlights the beneficial impact of MDT care on CRC outcomes. Further research with extended follow-up is warranted to confirm these findings.
本研究旨在评估多学科团队（MDT）管理与非MDT护理相比，是否能改善I-III期结直肠癌（CRC）患者的预后。本研究纳入了2017年至2018年在意大利北部一个省份诊断出的460例CRC患者，其中300例（65%）接受了MDT管理。接受MDT管理的患者更年轻，直肠癌患者更常见，诊断时处于更早阶段，且更有可能接受手术和化疗。MDT组的无病生存期（DFS）和总生存期（OS）明显更好。复发率为8.5%，MDT组和非MDT组患者之间无显著差异，尽管MDT组早期肿瘤患者的复发率较低。多变量分析显示，年龄较大、分期较晚和缺乏MDT管理会对DFS和OS产生不利影响。Kaplan-Meier估计显示，MDT组的3年DFS为78%，而非MDT组为65%，OS分别为83%和69%。MDT方法与提高治疗依从性和更好地管理复发相关。尽管受样本量小的限制，但这项基于人群的研究突出了MDT护理对CRC预后的有益影响。有必要进行进一步的长期随访研究以证实这些发现。
