Multidisciplinary Tumor Board Recommendations for Oligometastatic Malignancies: A Prospective Single-Center Analysis

Galata, Christian; Wimmer, Elisabeth; Kasper, Bernd; Wenz, Frederik; Reißfelder, Christoph; Jakob, Jens

doi:10.1159/000495474

Cited by 12 publications

(12 citation statements)

References 35 publications

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“…Data sources differed between the studies with some overlap as shown in Table 1. Three studies used MDT records (13,25,26), three used medical records (13,26,27), five used institutional registries (7,(10)(11)(12)27) and six used state or national administrative datasets or registries (8,9,(27)(28)(29)(30). Of the studies identified, 10/13 used data linkage, registry and/ or administrative data (7-12,27-30) with 3/13 basing their analyses on MDT or medical records (13,25,26).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies used MDT records (13,25,26), three used medical records (13,26,27), five used institutional registries (7,(10)(11)(12)27) and six used state or national administrative datasets or registries (8,9,(27)(28)(29)(30). Of the studies identified, 10/13 used data linkage, registry and/ or administrative data (7-12,27-30) with 3/13 basing their analyses on MDT or medical records (13,25,26). The three largest studies (with >10,000 cases) based their analyses on large, national registry and administrative datasets (9,28,30).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing lung cancer MDT data for maximum clinical impact—a scoping literature review

Rankin¹,

Currow²,

Fong³

et al. 2020

Transl Lung Cancer Res

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Multidisciplinary care in is widely recommended as best practice for lung cancer in many countries and jurisdictions. A number of studies suggest multidisciplinary care benefits patient outcomes, with analyses based on a range of data sources including national, state and local registries as well as multidisciplinary team meeting (MDT)-based data collections, often focused on different questions depending on data sources. MDT data collection and linkage are not standardized and not routine although data collection and feedback are specifically recommended by at least one statutory body. We performed a scoping review of current evidence for lung cancer MDT data collection and analysis, to identify discrete strategies through illustrative examples and to make recommendations for future approaches. Thirteen studies were identified that presented lung cancer MDT-related clinical outcomes, three included MDTs from multiple tumour streams while 10 studies focussed on lung cancer MDT meetings. Eleven studies measured the effect of MDT discussion on clinical outcomes of which eight were positive. Data sources included MDT records (3 studies), medical or hospital records (3 studies), institutional registries (5 studies) and state or national administrative datasets (6 studies), with some overlap. Examples of studies based on different data sources (local MDT, institutional registry, national registry) exemplified the different types of clinical research questions appropriate for each data source. While MDT data collection is not welldefined, the importance of clinical audit and data feedback and the potential for real-time analysis to improve outcomes deserve further investigation. Optimized datasets and linkage strategies are likely to maximize benefits for patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Optimizing lung cancer MDT data for maximum clinical impact—a scoping literature review

Rankin¹,

Currow²,

Fong³

et al. 2020

Transl Lung Cancer Res

View full text Add to dashboard Cite

show abstract

“…Particular consideration should be given to patients with low oligometastatic disease. These patients account for 15-55% of all metastatic patients from different primaries (45)(46)(47)(48). These patients represent a considerable proportion of all patients subjected to MDT decisions.…”

Section: Oligometastatic Diseasementioning

confidence: 99%

“…Lung cancer patients with low metastatic burdens represent a highly specific population, and some of them may be amenable for locoregional, potentially curative therapies (49,50). For example, in the Galata et al study (45) MDT recommended local therapy in 64.5% of oligometastatic lung cancer patients. However, owing to the lack of oligometastatic disease definition, selection of patients amenable to local approaches is still subjective.…”

Section: Oligometastatic Diseasementioning

confidence: 99%

Multidisciplinary team care in advanced lung cancer

Kowalczyk

Jassem

2020

Transl Lung Cancer Res

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Lung cancer is the most common cause of cancer mortality globally. A vast majority of lung cancer cases are diagnosed at advanced stages. Management of advanced lung cancer requires several diagnostic and therapeutic procedures provided by various specialists. To optimise the entire diagnostic and therapeutic process, a concept of care provided simultaneously by a multidisciplinary team (MDT) has been developed and implemented in specialised centres worldwide. Observational studies suggest that integrated and coordinated care increases adherence to clinical guidelines, significantly shortens the interval from diagnosis to treatment, and may increase survival and quality of life (QoL). Prospective studies are warranted to assess the real impact of MDT on treatment outcomes and to further refine this approach.

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“…More recently, the armamentarium of local approaches has been complemented by radiotherapy and thermal ablation treatments, such as radiofrequency ablation or cryotherapy, which spare patients from a more invasive procedure at the cost of unknown treatment margins. At present, patients with oligometastatic disease of various origins are routinely offered such a potentially curative treatment, sometimes using a sequential combination of different modalities, planned in a stepwise fashion and even repeatedly in the case of accessible recurrences (18,19).…”

Section: Distant Metastases: Who How and Whatmentioning

confidence: 99%

Oligometastatic Disease Management: Finding the Sweet Spot

Szturz¹,

Nevens

Vermorken

2020

Front. Oncol.

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Hematogenous dissemination represents a common manifestation of squamous cell carcinoma of the head and neck, and the recommended therapeutic options usually consist of systemically administered drugs with palliative intent. However, mounting evidence suggests that patients with few and slowly progressive distant lesions of small size may benefit from various local ablation techniques, which have already been established as standard-of-care modalities for example in colorectal and renal cell carcinomas and in sarcomas. In principle, serving as radical approaches to eradicate cancer, these interventions can be curative. Their impact on local control and overall survival has been shown in numerous retrospective and prospective studies. The term oligometastatic refers to the number of distant lesions which should generally not surpass five in total, ideally in one organ. Currently, surgical resection remains the method of choice supported by the majority of published data. More recently, stereotactic (ablative) body radiotherapy (SABR/SBRT) has emerged as a viable alternative. In cases technically amenable to such local interventions, several other clinical variables need to be taken into account also, including patient-related factors (general health status, patient preferences, socioeconomic background) and disease-related factors (primary tumor site, growth kinetics, synchronous or metachronous metastases). In head and neck cancer, patients presenting with late development of slowly progressive oligometastatic lesions in the lungs secondary to human papillomavirus (HPV)-positive oropharyngeal cancer are the ideal candidates for metastasectomy or other local therapies. However, literature data are still limited to say whether there are other subgroups benefiting from this approach. One of the plausible explanations is that radiological follow-up after primary curative therapy is usually not recommended because its impact on survival has not been unequivocal, which is also due to the rarity of oligometastatic manifestations in this disease. At the same time, aggressive treatment of synchronous metastases early in the disease course should be weighed against the risk of futile interventions in a disease with already multimetastatic microscopic dissemination. Therefore, attentive treatment sequencing, meticulous appraisal of cancer extension, refinement of post-treatment surveillance, and understanding of tumor biology and kinetics are crucial in the management of oligometastases.

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Multidisciplinary Tumor Board Recommendations for Oligometastatic Malignancies: A Prospective Single-Center Analysis

Cited by 12 publications

References 35 publications

Optimizing lung cancer MDT data for maximum clinical impact—a scoping literature review

Optimizing lung cancer MDT data for maximum clinical impact—a scoping literature review

Multidisciplinary team care in advanced lung cancer

Oligometastatic Disease Management: Finding the Sweet Spot

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