The impact of a multidisciplinary tumour board (MDTB) in the management of colorectal cancer (CRC)
Abstract Background: The management of colorectal cancer (CRC) is a complex process. Defining the disease burden, assessing the radiological response and identifying the right time for surgery or other locoregional treatments are crucial factors. Ensuring the accuracy of evaluations and making decisions about the most appropriate treatment strategy require the involvement of a multidisciplinary tumour board (MDTB) comprising surgeons, medical and radiation oncologists, radiologists, endoscopists, gastroenterologists and pathologists. This study investigates the impact of MDTB on management of CRC in our institution. Methods: We retrospectively assessed all cases discussed by our MDTB between September 2019 and Aprile 2023. In particular, we colected data concerning radiology (disease control/progression), surgery (yes/no) and radiotherapy indication (yes/no) before and after MDTB meetings. The primary endpoint was the overall raste of discrepancy between pre- and post-discussion evaluations. Results: Our analysis involved 1150 cases. Median age was 64 years (16-90), 629 patients (54.7%) were male and 915 (79.5%) had metastatic disease at the time of the relevant MDTB discussion. After the meetings, 325 treatment decisions were modified, producing an overall discrepancy rate of 28.3%. In particular: (a) of 648 cases discussed for radiological assessment, 156 decisions (24.1%) were altered after a central imaging review, with 73 cases initially assessed as progressed disease subsequently defined as stable; (b) of 327 cases considered for surgical approach, treament strategy changed in 118 (36.1%). More specifically, 25 cases evaluated as unresectable before the MDTB meeting were considered to be resectable thereafter; and (c) of the 160 cases discussed regarding radiotherapy, the treatment strategy changed in 51 of them (31.9%). Conclusions: Our analysis demonstrates significant discrepancies between the radiology and locoregional evaluations from both before and after the MDTB meetings. Our results highlight that the discussions of a MDTB can considerably change the management of CRC, maximising the treatment strategy..
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Preprint| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
ResearchSquare.com - (2024) vom: 14. Feb. Zur Gesamtaufnahme - year:2024 |
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| Sprache: |
Englisch |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.21203/rs.3.rs-3895351/v1 |
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XRA042488621 |
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| 520 | |a Abstract Background: The management of colorectal cancer (CRC) is a complex process. Defining the disease burden, assessing the radiological response and identifying the right time for surgery or other locoregional treatments are crucial factors. Ensuring the accuracy of evaluations and making decisions about the most appropriate treatment strategy require the involvement of a multidisciplinary tumour board (MDTB) comprising surgeons, medical and radiation oncologists, radiologists, endoscopists, gastroenterologists and pathologists. This study investigates the impact of MDTB on management of CRC in our institution. Methods: We retrospectively assessed all cases discussed by our MDTB between September 2019 and Aprile 2023. In particular, we colected data concerning radiology (disease control/progression), surgery (yes/no) and radiotherapy indication (yes/no) before and after MDTB meetings. The primary endpoint was the overall raste of discrepancy between pre- and post-discussion evaluations. Results: Our analysis involved 1150 cases. Median age was 64 years (16-90), 629 patients (54.7%) were male and 915 (79.5%) had metastatic disease at the time of the relevant MDTB discussion. After the meetings, 325 treatment decisions were modified, producing an overall discrepancy rate of 28.3%. In particular: (a) of 648 cases discussed for radiological assessment, 156 decisions (24.1%) were altered after a central imaging review, with 73 cases initially assessed as progressed disease subsequently defined as stable; (b) of 327 cases considered for surgical approach, treament strategy changed in 118 (36.1%). More specifically, 25 cases evaluated as unresectable before the MDTB meeting were considered to be resectable thereafter; and (c) of the 160 cases discussed regarding radiotherapy, the treatment strategy changed in 51 of them (31.9%). Conclusions: Our analysis demonstrates significant discrepancies between the radiology and locoregional evaluations from both before and after the MDTB meetings. Our results highlight that the discussions of a MDTB can considerably change the management of CRC, maximising the treatment strategy. | ||
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