China special issue on gastrointestinal tumors‐Improved survival after multidisciplinary team decision for patients with advanced gastrointestinal cancer: A multicenter, noninterventional, controlled study

Abstract

Formal multidisciplinary team (MDT) discussions in clinical practice require time and space but have unclear survival benefits for advanced gastrointestinal cancer patients. Our study aimed to investigate the long‐term survival of patients with advanced gastrointestinal cancer after MDT decision. From June 2017 to June 2019, continuous MDT discussions on advanced gastrointestinal cancer were conducted in 13 medical centers in China. MDT decisions and actual treatment received by patients were prospectively recorded. The primary endpoint was the difference in overall survival (OS) between patients in the MDT decision implementation and nonimplementation groups. The secondary endpoints included the implementation rate of MDT decisions and subgroup survival analysis. A total of 461 MDT decisions of 455 patients were included in our study. The implementation rate of MDT decisions was 85.7%. Previous treatment had an impact on MDT decision‐making. The OS was 24.0 months and 17.0 months in the implementation and nonimplementation groups, respectively. The implementation of MDT decisions significantly reduced the risk of death in multivariate analyses (hazard ratio = 0.518; 95% confidence interval: 0.304‐0.884, P = .016). Subgroup analysis showed a significant difference in survival of patients with colorectal cancer, but not in survival of patients with gastric cancer. The rate of secondary MDT discussion was only 5.6% among patients who the MDT decisions were discontinued due to changes in their condition. MDT discussion can prolong the OS of patients with advanced gastrointestinal cancer, especially those with colorectal cancer. Timely scheduling of the subsequent MDT discussion is necessary when the disease condition changes.

Current landscape of preoperative neoadjuvant therapies for initial resectable colorectal cancer liver metastasis

“…Extensive evidence supports the impact of MDT processes on patient survival, demonstrating improved OS under MDT care[ 40 , 41 ]. Notably, a Chinese study reported that MDT discussions contributed to prolonged OS in patients with advanced gastrointestinal cancers, including CRC[ 42 ]. Additionally, preoperative MDT assessment has shown associations with enhanced survival in patients with locally advanced colon cancer[ 43 ].…”

Association between increased C-reactive protein and cardiovascular disease among patients with rectal cancer

“…Multidisciplinary management has significantly extended the survival of patients with rectal cancer, increasing the number of rectal cancer survivors (1)(2)(3). Subsequently, the problem of chronic cardiovascular disease is also highlighted in these survivors, who are more predisposed to developing cardiovascular disease (CVD) than those without a history of cancer (4,5).…”