Multidisciplinary Team (MDT) Discussion Improves Overall Survival Outcomes for Metastatic Renal Cell Carcinoma Patients

Zeng, Yu-Hao; Zhu, Sha; Wang, Zilin; Chen, Junru; Dai, Jindong; Liu, Zhenhua; Sun, Guangxi; Liang, Jiayu; Zhang, Xingming; Wang, Zhipeng; Zhao, Jinge; Ni, Yang; Yang, Jiyu; Wang, Minghao; Wei, Qiang; Li, Xiang; Chen, Ni; Li, Zhiping; Wang, Xin; Shen, Yali; Yao, Jin; Huang, Rui; Liu, Jiyan; Cai, Diming; Zeng, Hao; Shen, Pengfei

doi:10.2147/jmdh.s393457

Cited by 9 publications

(5 citation statements)

References 22 publications

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Section: Discussionmentioning

confidence: 99%

“…Multidisciplinary management represents significant progress in oncology of solid tumors in the past 20 years, bringing favorable results in treating various tumors and continuously improving the treatment outcome. 15 , 16 , 17 However, in a narrow sense, the multidisciplinary team is usually referred to different specialties engaged in the management of the same cancer type. For example, with lung cancer specialty, the multidisciplinary team includes lung cancer surgeons, oncologists, radiologists, and physicians who diagnose lung cancer.…”

Section: Discussionmentioning

confidence: 99%

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Considerations for multidisciplinary management of synchronous primary breast cancer and primary lung cancer – Analysis of thirty‐one patients

Chen,

Fang,

Yan

2024

Thoracic Cancer

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BackgroundThe simultaneous (synchronous) presence of primary breast cancer and primary lung cancer diagnosed in a single individual is not an uncommon phenomenon. However, reference data for treatment strategy is scarce and “chaotic”. In the present study we discuss the management strategy for this group of patients.MethodsWe retrospectively reviewed patients in the primary breast cancer database of the Breast Center and the primary lung cancer database of the Thoracic Surgery Department I of Peking University Cancer Hospital. Patients with synchronous primary breast cancer and primary lung cancer who underwent surgery between December 2010 and December 2023 were included in the study. The sequence of outpatient visits, recommendations of multidisciplinary teams, perioperative treatment, and surgical procedures were reviewed. Meanwhile, survival analysis based on propensity score matching with 1:1 ratio was performed between the 31 patients and those with lung cancer only during the same period.ResultsA total of 31 patients with synchronous primary breast cancer and primary lung cancer were identified; all of the patients were women. The average age was 61 years. A total of 24 of the patients had visited the breast center first, and routine chest computed tomography (CT) showed evidence of primary lung cancer. The other seven patients had visited the thoracic surgery clinic first, and routine positron emission tomography (PET)‐CT revealed the coexistence of primary breast cancer. All the patients had multidisciplinary team consultations, after which 20 patients were recommended to have preoperative treatment for breast cancer, two patients were recommended to have preoperative treatment for lung cancer, and nine patients were recommended to undergo surgery directly. After surgery, 23 patients received postoperative adjuvant treatment for breast cancer, and no patients needed postoperative adjuvant treatment for lung cancer. Survival analysis showed that there was no significant difference between the 31 patients and those with lung cancer only.ConclusionRoutine chest CT is needed for breast cancer patients before surgery, and PET‐CT is required for the accurate staging of lung cancer patients. A multidisciplinary expert team should manage synchronous primary breast cancer and primary lung cancer. Emphasis should be placed on patients who need preoperative treatment before surgery. Particularly, for patients who need preoperative chemotherapy, a regimen should be chosen that balances the treatment of lung cancer and breast cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Considerations for multidisciplinary management of synchronous primary breast cancer and primary lung cancer – Analysis of thirty‐one patients

Chen,

Fang,

Yan

2024

Thoracic Cancer

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“…This lack of literature in this onco-nephrological field has to be filled because nutritional status influences cancer, prognosis, quality of life (QoL), and co-morbidities [15]. Therefore, it is crucial to implement interventions to evaluate and enhance these patients' nutritional status because malnutrition can significantly impact the effectiveness of treatment and the overall outcomes for individuals with RCC [15,20]. Preventing undernourishment is a key target of nutritional interventions for CKD and cancer.…”

Section: Discussionmentioning

confidence: 99%

“…This cohort of patients experiences the sudden removal of a kidney, resulting in the loss of half of their renal endowment [16,17]. As a consequence, the development of renal dysfunction due to the surgical removal of nephron mass implicates a proper multidisciplinary approach between urologists, oncologists, and nephrologists with immediate effect in order to maintain the correct clinical balance to avoid the severe stages of AKI, AKD, and CKD on one side, and to treat cancer on the other [18][19][20]. However, few reports in the literature are present in terms of nutritional regimen in this scenario because specialists usually tend to give prominence to clinical aspects as opposed to diet and, as a consequence, some patients are treated with high protein intakes, some with low protein quotas, and others with a self-determined diet [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Effects of a Personalized Diet on Nutritional Status and Renal Function Outcome in Nephrectomized Patients with Renal Cancer

Trevisani,

Laurenti,

Fiorio

et al. 2024

Nutrients

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Nutritional therapy (NT) based on a controlled protein intake represents a cornerstone in managing chronic kidney disease (CKD). However, if a CKD patient is at the same time affected by cancer, oncologists and nutritionists tend to suggest a dietary regimen based on high protein intake to avoid catabolism and malnutrition. International guidelines are not clear when we consider onco-nephrological patients and, as a consequence, no clinical shared strategy is currently applied in clinical practice. In particular, no precise nutritional management is established in nephrectomized patients for renal cell carcinoma (RCC), a specific oncological cohort of patients whose sudden kidney removal forces the remnant one to start a compensatory mechanism of adaptive hyperfiltration. Our study aimed to investigate the efficacy of a low–normal-protein high-calorie (LNPHC) diet based on a Mediterranean model in a consecutive cohort of nephrectomized RCC patients using an integrated nephrologist and nutritionist approach. A consecutive cohort of 40 nephrectomized RCC adult (age > 18) patients who were screened for malnutrition (malnutrition screening tool, MST < 2) were enrolled in a tertiary institution between 2020 and 2022 after signing a specific informed consent form. Each patient underwent an initial nephrological and nutritional evaluation and was subsequently subjected to a conventional CKD LNPHC diet integrated with aproteic foods (0.8 g/Kg/die: calories: 30–35 kcal per kg body weight/die) for a period of 6 months (±2 months). The diet was structured after considering eGFR (CKD-EPI 2021 creatinine formula), comorbidities, and nutritional status. MST, body mass index (BMI), phase angle (PA), fat mass percentage (FM%), fat-free mass index (FFMI), body cell mass index (BCMI), extracellular/intracellular water ratio (ECW/ICW), extracellular matrix/body cell mass ratio (ECM/BCM), waist/hip circumference ratio (WHC), lab test exams, and clinical variables were examined at baseline and after the study period. Our results clearly highlighted that the LNPHC diet was able to significantly improve several nutritional parameters, avoiding malnutrition and catabolism. In particular, the LNPHC diet preserved the BCM index (delta on median, ΔM + 0.3 kg/m2) and reduced the ECM/BCM ratio (ΔM − 0.03 *), with a significant reduction in the ECW/ICW ratio (ΔM − 0.02 *), all while increasing TBW (ΔM + 2.3% *). The LNPHC diet was able to preserve FFM while simultaneously depleting FM and, moreover, it led to a significant reduction in urea (ΔM − 11 mg/dL **). In conclusion, the LNPHC diet represents a new important therapeutic strategy that should be considered when treating onco-nephrological patients with solitary kidney due to renal cancer.

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“…It means that the crucial element of patients bene tting from MDT consultations in complicated genitourinary tumors maybe the compliance with MDT recommendations. Many studies were observed to prove that patients with genitourinary cancers bene ted from MDT (19,27), but there were few studies focused on the clinical bene t for patients with complicated genitourinary cancers through MDT based on their compliance. Our study concentrated on their compliance and made up for this de ciency.…”

Section: Discussionmentioning

confidence: 99%

Compliance with MDT recommendations is the key element for patients to benefit from MDT in complicated genitourinary tumors: a single-center data set

Huang

et al. 2023

Preprint

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Purpose: This study aims to evaluate the applications and benefits of the multiple-disciplinary team (MDT) model in the clinical practices of complicated genitourinary tumors and to explore the importance of patients’ compliance with MDT recommendations. Methods: This was a descriptive study of 259 MDT consultations in our center over the past five years (2018-2022). All data recorded in the database were retrospectively analyzed, including clinical history, initial decisions, MDT decisions, actual treatments, and efficacy assessments. Results: A total of 259 consultations were performed on 222 patients with an average age of 65.21±12.87 years old (range,18 to 92 years old). Of the 259 consultations, 149 (57.5%) were for prostate cancer, 48 (18.5%) for kidney cancer, 24 (9.3%) for bladder cancer, 13 (5.0%) forupper tract urothelial cancer, 6 (2.3%) for testicular cancer, 2 (0.8%) for adrenal gland cancer, 6 (2.3%) for multiple primary tumors and 11 (4.2%) for other problems. Patients fully accepted the MDT recommendations in 201 consultations (77.6%); Partially accepted the MDT recommendations in 32 consultations (12.4%). The total rate of compliance was about 90.0% and 226 patients benefitted in the compliance group. Only 2 patients benefitted after MDT consultations in the noncompliance group. Compliance with MDT recommendations was found to be more beneficial for patients than the non-compliance group in our study (P＜0.001). Conclusion: Our findings suggest that MDT should be recommended for patients with complicated genitourinary cancers. Compliance with recommendations is the key element for patients benefitted from MDT consultations and we should focus on ways to enhance patients’ adherence.

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Multidisciplinary Team (MDT) Discussion Improves Overall Survival Outcomes for Metastatic Renal Cell Carcinoma Patients

Cited by 9 publications

References 22 publications

Considerations for multidisciplinary management of synchronous primary breast cancer and primary lung cancer – Analysis of thirty‐one patients

Considerations for multidisciplinary management of synchronous primary breast cancer and primary lung cancer – Analysis of thirty‐one patients

Effects of a Personalized Diet on Nutritional Status and Renal Function Outcome in Nephrectomized Patients with Renal Cancer

Compliance with MDT recommendations is the key element for patients to benefit from MDT in complicated genitourinary tumors: a single-center data set

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