Survival Impact and Cost-Effectiveness of a Multidisciplinary Tumor Board for Breast Cancer in Mozambique, Sub-Saharan Africa

Brandão, Mariana; Guisseve, Assucena; Bata, Genoveva; Firmino-Machado, João; Alberto, Matos; Ferro, Josefo; García, Carlos; Zaqueu, Clésio; Jamisse, Astrilde; Lorenzoni, Cesaltina; Piccart‐Gebhart, Martine; Leitão, Dina; Come, Jotamo; Soares, Otília; Gudo-Morais, Alberto; Schmitt, Fernando; Tulsidâs, Satish; Carrilho, Carla; Lunet, Nuno

doi:10.1002/onco.13643

Cited by 21 publications

(44 citation statements)

References 36 publications

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“…Forty-one articles investigated the effect of MDTMs on cancer care pathways in colorectal cancer (21/41) , lung cancer (10/41) [38][39][40][41][42][43][44][45][46][47], prostate cancer (6/41) [48][49][50][51][52][53] and breast cancer (4/41) [54][55][56][57] (Table 1). All studies were conducted in adults (total n = 82,073, range 42-32,569 study subjects per study, mean 2002), with studies originating from in Oceania (8/41) [20,26,29,38,39,43,45,52], Asia (9/41) [18,21,23,35,41,46,50,56,57], Europe (13/41) [17,19,24,25,27,31,32,34,36,37,44,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All studies were conducted in adults (total n = 82,073, range 42-32,569 study subjects per study, mean 2002), with studies originating from in Oceania (8/41) [20,26,29,38,39,43,45,52], Asia (9/41) [18,21,23,35,41,46,50,56,57], Europe (13/41) [17,19,24,25,27,31,32,34,36,37,44,48,49], North America (10/41) [22,28,30,33,40,42,47,51,53,54] or Africa (1/41) [55]. Studies were performed in multicenter (6/41) [34,37,38,40,41,56] or single-center (35/41) [17][18]…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In general, members of MDTMs include surgeons, (radiation) oncologists, radiologists, pathologists, residents and nurses. The frequency of MDTMs ranged from 4 times a week [21], to weekly [17,19,20,[22][23][24][25]29,[33][34][35][36]38,39,[42][43][44][45][46]49,[52][53][54][55] to biweekly [26,28,30,40,47,48]. Ten articles provided limited or no information on the frequency of MDTMs [18,27,31,32,37,41,50,51,56,57].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The outcomes measured in the articles were changes in or differences between: (1) process outcomes (9/41), (2) patient management (34/41) and (3) patient outcomes (18/41). Studies using a before-after study design (12/41) [17,23,24,26,28,32,[34][35][36]44,46,55] or a casecontrol study design (13/41) [18,20,25,27,31,33,[37][38][39][40]43,47,56] investigated a combination of all three outcome groups. When a cohort study design (16/41) [19,21,22,29,30,41,42,45,[48][49][50][51][52][53][54]57] was used, most investigated patient management (13/16).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…With the use of the Robins-I tool, the risk of bias was rated critical in 22 studies (22/41) [17][18][19][20][21][22][23][25][26][27][30][31][32][33][34][35]42,44,46,49,50,53] and serious in 17 studies (17/41) [24,28,29,[36][37][38][39][40][41]43,45,47,48,52,[55][56][57]. Two studies showed no clear indication of serious or critical risk of bias but lacked information in one or more key domains of bias that hampered proper determination of overall risk of bias [51,54].…”

Section: Risk Of Bias and Quality Of Evidence Assessmentmentioning

confidence: 99%

See 4 more Smart Citations

The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

Kočo

Weekenstroo

Lambregts

et al. 2021

Cancers

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Objective: The aim of our systematic review is to identify the effects of multidisciplinary team meetings (MDTM) for lung, breast, colorectal and prostate cancer. Methods: Our systematic review, performed following PRISMA guidelines, included studies examining the impact of MDTMs on treatment decisions, patient and process outcomes. Electronic databases PUBMED, EMBASE, Cochrane Library and Web of Science were searched for articles published between 2000 and 2020. Risk of bias and level of evidence were assessed using the ROBINS-I tool and GRADE scale. Results: 41 of 13,246 articles were selected, evaluating colorectal (21), lung (10), prostate (6) and breast (4) cancer. Results showed that management plans were changed in 1.6–58% of cases after MDTMs. Studies reported a significant impact of MDTMs on surgery type, and a reduction of overall performed surgery after MDTM. Results also suggest that CT and MRI imaging significantly increased after MDTM implementation. Survival rate increased significantly with MDTM discussions according to twelve studies, yet three studies did not show significant differences. Conclusions: Despite heterogeneous data, MDTMs showed a significant impact on management plans, process outcomes and patient outcomes. To further explore the impact of MDTMs on the quality of healthcare, high-quality research is needed.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias and Quality Of Evidence Assessmentmentioning

confidence: 99%

See 3 more Smart Citations

The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

Kočo

Weekenstroo

Lambregts

et al. 2021

Cancers

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Female breast cancer in sub‐Saharan Africa: A PRISMA‐S‐compliant systematic review of surgery

Amouzou

Ketevi

Sambiani

et al. 2021

Journal of Surgical Oncology

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Background In sub‐Saharan countries (SSAs), the advanced stage at diagnosis and the limited surgical interventions of female breast cancer (FBC) lead to poor outcomes. This study assessed current modalities of FBC surgeries. Methods Six literature databases (Medline, Embase, African Journal Online, Google Scholar, Web of Science, Cochrane Library) were searched, plus a manual search, in 2011–2021. We included primary data studies with any setting and presurgeries or postsurgeries treatments, we excluded non‐English language studies, editorials, and grey literature. Results The search yielded 21 observational studies (16 retrospective, 3 prospective, and 2 case reports). Of the total 6900 patients, 4121 (60%) patients underwent FBC surgical excision only, and 751/2779 (27%) conservative surgery (BCS) or therapy (BCT). All studies reported similar use of mastectomy (>60%), the FBC surgical excision/reconstruction studies displayed more neoadjuvant chemotherapy (536/2779, 19% vs. 215/4121, 5%), and radiotherapy or adjuvant radiotherapy (1461/2779, 52% vs. 411/3921, 4%). Patients' age, histological classification, staging, and follow‐up data were often missing. Conclusions The FBC complexity requires structured management by general and plastic surgeons, radiotherapy specialists, and obstetrician‐gynecologists through shared guidelines, protocols, and specific programs of public health. In SSAs, FBC surgical strategies should point at decreasing radical mastectomy and increasing BCS/BCT.

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Evaluating ChatGPT as an adjunct for the multidisciplinary tumor board decision-making in primary breast cancer cases

Lukac

Dayan

Fink

et al. 2023

Arch Gynecol Obstet

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Background As the available information about breast cancer is growing every day, the decision-making process for the therapy is getting more complex. ChatGPT as a transformer-based language model possesses the ability to write scientific articles and pass medical exams. But is it able to support the multidisciplinary tumor board (MDT) in the planning of the therapy of patients with breast cancer? Material and Methods We performed a pilot study on 10 consecutive cases of breast cancer patients discussed in MDT at our department in January 2023. Included were patients with a primary diagnosis of early breast cancer. The recommendation of MDT was compared with the recommendation of the ChatGPT for particular patients and the clinical score of the agreement was calculated. Results Results showed that ChatGPT provided mostly general answers regarding chemotherapy, breast surgery, radiation therapy, chemotherapy, and antibody therapy. It was able to identify risk factors for hereditary breast cancer and point out the elderly patient indicated for chemotherapy to evaluate the cost/benefit effect. ChatGPT wrongly identified the patient with Her2 1 + and 2 + (FISH negative) as in need of therapy with an antibody and called endocrine therapy “hormonal treatment”. Conclusions Support of artificial intelligence by finding individualized and personalized therapy for our patients in the time of rapidly expanding amount of information is looking for the ways in the clinical routine. ChatGPT has the potential to find its spot in clinical medicine, but the current version is not able to provide specific recommendations for the therapy of patients with primary breast cancer.

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Survival Impact and Cost-Effectiveness of a Multidisciplinary Tumor Board for Breast Cancer in Mozambique, Sub-Saharan Africa

Abstract: Disclosures of potential conflicts of interest may be found at the end of this article.

Cited by 21 publications

References 36 publications

The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

Female breast cancer in sub‐Saharan Africa: A PRISMA‐S‐compliant systematic review of surgery

Evaluating ChatGPT as an adjunct for the multidisciplinary tumor board decision-making in primary breast cancer cases

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