Effect of multidisciplinary team treatment on outcomes of patients with gastrointestinal malignancy

被引:102
作者
Du, Chang-Zheng [1 ]
Li, Jie [2 ]
Cai, Yong [3 ]
Sun, Ying-Shi [4 ]
Xue, Wei-Cheng [5 ]
Gu, Jin [1 ]
机构
[1] Peking Univ, Dept Colorectal Surg, Sch Oncol, Beijing 100142, Peoples R China
[2] Peking Univ, Dept Med Oncol, Sch Oncol, Beijing 100142, Peoples R China
[3] Peking Univ, Dept Radiotherapy, Sch Oncol, Beijing 100142, Peoples R China
[4] Peking Univ, Dept Radiol, Sch Oncol, Beijing 100142, Peoples R China
[5] Peking Univ, Dept Pathol, Sch Oncol, Beijing 100142, Peoples R China
关键词
Multidisciplinary team; Rectal cancer; Neoadjuvant radiotherapy; Prognosis; ADVANCED COLORECTAL-CANCER; LOW RECTAL-CANCER; PREOPERATIVE RADIOTHERAPY; SPHINCTER PRESERVATION; PROGNOSTIC-FACTORS; MANAGEMENT; SURVIVAL; MARGINS; SURGERY; IMPACT;
D O I
10.3748/wjg.v17.i15.2013
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
AIM: To evaluate the effect of multidisciplinary team (MDT) treatment modality on outcomes of patients with gastrointestinal malignancy in China. METHODS: Data about patients with gastric and colorectal cancer treated in our center during the past 10 years were collected and divided into two parts. Part 1 consisted of the data collected from 516 consecutive complicated cases discussed at MDT meetings in Peking University School of Oncology (PKUSO) from December 2005 to July 2009. Part 2 consisted of the data collected from 263 consecutive cases of resectable locally advanced rectal cancer from January 2001 to January 2005. These 263 patients were divided into neoadjuvant therapy (NT) group and control group. Patients in NT group received MDT treatment, namely neoadjuvant therapy + surgery + postoperative adjuvant therapy. Patients in control group underwent direct surgery + postoperative adjuvant therapy. The outcomes in two groups were compared. RESULTS: The treatment strategy was altered after discussed at MDT meeting in 76.81% of gastric cancer patients and in 58.33% of colorectal cancer patients before operation. The sphincter-preservation and local control of tumor were better in NT group than in control group. The 5-year overall survival rate was also higher in NT group than in control group (77.23% vs 69.75%, P = 0.049). CONCLUSION: MDT treatment modality can significantly improve the outcomes of patients with gastrointestinal malignancy in China. (C) 2011 Baishideng. All rights reserved.
引用
收藏
页码:2013 / 2018
页数:6
相关论文
共 29 条
[1]
[Anonymous], 2006, BMJ, V333, P779
[2]
Multidisciplinary treatment of rectal cancer: medical oncology [J].
Aschele, C. ;
Lonardi, S. .
ANNALS OF ONCOLOGY, 2007, 18 :114-121
[3]
Analysis of clinical decision-making in multi-disciplinary cancer teams [J].
Blazeby, JM ;
Wilson, L ;
Metcalfe, C ;
Nicklin, J ;
English, R ;
Donovan, JL .
ANNALS OF ONCOLOGY, 2006, 17 (03) :457-460
[4]
Chemotherapy with preoperative radiotherapy in rectal cancer [J].
Bosset, Jean-Francois ;
Collette, Laurence ;
Calais, Gilles ;
Mineur, Laurent ;
Maingon, Philippe ;
Radosevic-Jelic, Ljiljana ;
Daban, Alain ;
Bardet, Etienne ;
Beny, Alexander ;
Ollier, Jean-Claude .
NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (11) :1114-1123
[5]
Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging [J].
Brown, G ;
Radcliffe, AG ;
Newcombe, RG ;
Dallimore, NS ;
Bourne, MW ;
Williams, GT .
BRITISH JOURNAL OF SURGERY, 2003, 90 (03) :355-364
[6]
MRI directed multidisciplinary team preoperative treatment strategy: the way to eliminate positive circumferential margins? [J].
Burton, S ;
Brown, G ;
Daniels, IR ;
Norman, AR ;
Mason, B ;
Cunningham, D .
BRITISH JOURNAL OF CANCER, 2006, 94 (03) :351-357
[7]
Multidisciplinary team working, clinical networks, and chambers; opportunities to work differently in the NHS [J].
Carter, S ;
Garside, P ;
Black, A .
QUALITY & SAFETY IN HEALTH CARE, 2003, 12 :I25-I28
[8]
Progress in the multidisciplinary treatment of gastrointestinal cancer and the impact on clinical practice:: perioperative management of rectal cancer [J].
Cervantes, A. ;
Rosello, S. ;
Rodriguez-Braun, E. ;
Navarro, S. ;
Campos, S. ;
Hernandez, A. ;
Garcia-Granero, E. .
ANNALS OF ONCOLOGY, 2008, 19 :266-272
[9]
Integrative decisions in rectal cancer [J].
Cervantes, A. ;
Rodriguez-Braun, E. ;
Navarro, S. ;
Hernandez, A. ;
Campos, S. ;
Garcia-Granero, E. .
ANNALS OF ONCOLOGY, 2007, 18 :127-131
[10]
Practising evidence-based medicine: the design and implementation of a multidisciplinary team-driven extubation protocol [J].
Chan, PKO ;
Fischer, S ;
Stewart, TE ;
Hallett, DC ;
Hynes-Gay, P ;
Lapinsky, SE ;
MacDonald, R ;
Mehta, S .
CRITICAL CARE, 2001, 5 (06) :349-354