Jiang Wenheng, Dou Xue, Zhang Nan, Yu Jinming, Zhao Lei, Yue Jinbo
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Department of Preventive Management, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Clin Colorectal Cancer. 2025 Jun;24(2):198-206.e5. doi: 10.1016/j.clcc.2024.12.006. Epub 2024 Dec 28.
Multidisciplinary team (MDT) meetings have been increasingly recognized for enhancing cancer treatment outcomes; however, their specific impact on stage II-III rectal cancer remains to be fully elucidated.
This retrospective cohort study investigated the influence of MDT meeting on disease-free survival (DFS) and overall survival (OS) in patients with stage II-III rectal cancer. Propensity score matching (PSM) was used to minimize selection bias. Kaplan-Meier survival analysis and Cox proportional hazards models were used to compare DFS and OS between groups.
A total of 502 patients were included, with 176 whose cases were discussed in MDT meetings and 326 who did not undergo MDT discussions. After PSM, 173 patients were matched in each group. The MDT group exhibited a significantly improved DFS compared to the non-MDT group, both before PSM (HR = 0.618, P = .037) and after PSM (HR = 0.545, P = .012). Subgroup analysis indicated notable benefits of MDT discussions for patients with T3 to 4 tumors, low to mid tumor locations, and node-positive tumors. While there was a trend towards improved OS in the MDT group, this did not reach statistical significance. More MDT group patients received MRI staging and neoadjuvant therapy compared to non-MDT group.
Discussion in MDT meetings is associated with improved DFS in stage II-III rectal cancer, particularly among patients with locally advanced, low to mid rectal cancer. These findings underscore the importance of incorporating MDT discussions into routine clinical practice to optimize outcomes for rectal cancer patients.
多学科团队（MDT）会议在提高癌症治疗效果方面日益受到认可；然而，其对II - III期直肠癌的具体影响仍有待充分阐明。
这项回顾性队列研究调查了MDT会议对II - III期直肠癌患者无病生存期（DFS）和总生存期（OS）的影响。采用倾向评分匹配（PSM）以尽量减少选择偏倚。使用Kaplan - Meier生存分析和Cox比例风险模型比较各组之间的DFS和OS。
共纳入502例患者，其中176例患者的病例在MDT会议上进行了讨论，326例未进行MDT讨论。PSM后，每组匹配173例患者。在PSM之前（HR = 0.618，P = 0.037）和之后（HR = 0.545，P = 0.012），MDT组的DFS均显著优于非MDT组。亚组分析表明，MDT讨论对T3至4期肿瘤、肿瘤位置低至中等以及淋巴结阳性肿瘤的患者有显著益处。虽然MDT组的OS有改善趋势，但未达到统计学意义。与非MDT组相比，更多MDT组患者接受了MRI分期和新辅助治疗。
MDT会议中的讨论与II - III期直肠癌患者DFS的改善相关，特别是在局部晚期、直肠中低位癌患者中。这些发现强调了将MDT讨论纳入常规临床实践以优化直肠癌患者治疗效果的重要性。
