Kandemir Esin Aysel, Roeper Julia, Zimmermann Heiner, Ansmann Lena, Hülper Petra, Bockhorn Maximilian, Köhne Claus-Henning, Griesinger Frank
School of Medicine and Health Sciences, University Department Internal Medicine-Oncology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
School of Medicine and Health Sciences, Department of Health Services Research, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany.
J Gastrointest Cancer. 2025 May 30;56(1):124. doi: 10.1007/s12029-025-01246-4.
Multidisciplinary tumor boards (MTBs) intend to increase the quality of cancer care. Research on the association of adherence to MTB recommendations with survival is limited. This study aims to determine the impact of adherence to MTB recommendations on survival in colorectal cancer patients.
This is a retrospective, observational study including patients diagnosed between 01.01.2014 and 31.12.2018. Electronic health records were reviewed to determine the adherence. Study endpoints were adherence rate, disease-free survival (DFS), and overall survival (OS). Follow-up was performed until 12.12.2023.
There was a significant difference in DFS (median DFS: 79 months [95% CI, 73-89] vs 22 months [95% CI, 17-87]) and OS (median OS: 78 months [95% CI, 75-86] vs 65 months [95% CI, 28-NR]) between the adherent group (n=406) versus the non-adherent group (n=52) (log-rank test, p<0.05). Performance status, stage and non-adherence were independent predictors of survival in the multivariate analysis (p<0.05 for all). The most common reason for non-adherence was patient preference (n=23).
While MTBs have become an indispensable part of clinical practice, adherence to MTB recommendations was crucial to achieve survival benefit in this study. Patient preference should be prospectively analyzed from a patient and caregiver perspective in future studies.
多学科肿瘤专家会诊（MTB）旨在提高癌症护理质量。关于遵循MTB建议与生存之间关联的研究有限。本研究旨在确定遵循MTB建议对结直肠癌患者生存的影响。
这是一项回顾性观察研究，纳入了2014年1月1日至2018年12月31日期间确诊的患者。通过查阅电子健康记录来确定依从性。研究终点为依从率、无病生存期（DFS）和总生存期（OS）。随访至2023年12月12日。
依从组（n = 406）与非依从组（n = 52）之间的DFS（中位DFS：79个月[95%CI，73 - 89]对22个月[95%CI，17 - 87]）和OS（中位OS：78个月[95%CI，75 - 86]对65个月[95%CI，28 - NR]）存在显著差异（对数秩检验，p < 0.05）。在多变量分析中，体能状态、分期和不依从是生存的独立预测因素（所有p均< 0.05）。最常见的不依从原因是患者偏好（n = 23）。
虽然MTB已成为临床实践中不可或缺的一部分，但在本研究中，遵循MTB建议对于获得生存益处至关重要。未来研究应从患者和护理人员的角度对患者偏好进行前瞻性分析。
