Management of colon cancer patients: A comprehensive analysis of the absence of multidisciplinary team meetings in two French departments

Foucan, A.S.; Grosclaude, Pascale; Bousser, Véronique; Bauvin, Eric; Smith, Denis; Andre-Fardeau, Céline; Daubisse‐Marliac, Laetitia; Mathoulin‐Pélissier, Simone; Amadéo, Brice; Coureau, Gaëlle

doi:10.1016/j.clinre.2020.02.020

Cited by 4 publications

(17 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…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]. 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).…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

Active involvement of patients, radiation oncologists, and surgeons in a multidisciplinary team approach: Guiding local therapy in recurrent, metastatic rectal cancer

Choi,

Yang,

Koom

et al. 2023

Cancer Medicine

View full text Add to dashboard Cite

BackgroundDespite the extensive implementation of an organized multidisciplinary team (MDT) approach in cancer treatment, there is little evidence regarding the optimal format of MDT. We aimed to investigate the impact of patient participation in MDT care on the actual application rate of metastasis‐directed local therapy.MethodsWe identified all 1211 patients with locally advanced rectal cancer treated with neoadjuvant radiochemotherapy at a single institution from 2006 to 2018. Practice patterns, tumor burden and OMD state were analyzed in recurrent, metastatic cases.ResultsWith a median follow‐up of 60.7 months, 281 patients developed metastases, and 96 (34.2%), 92 (32.7%), and 93 (33.1%) patients had 1, 2–5, and >5 lesions, respectively. In our study, 27.1% were managed in the MDT clinic that mandated the participation of at least four to five board‐certified multidisciplinary experts and patients in decision‐making processes, while the rest were managed through diverse MDT approaches such as conferences, tumor board meetings, and discussions conducted via phone calls or email. Management in MDT clinic was significantly associated with more use of radiotherapy (p = 0.003) and more sessions of local therapy (p < 0.001). At the time of MDT clinic, the number of lesions was 1, 2–5, and >5 in 9 (13.6%), 35 (53.1%), and 19 (28.8%) patients, respectively. The most common states were repeat OMD (28.8%) and de novo OMD (27.3%), followed by oligoprogression (15%) and induced OMD (10.6%).ConclusionOur findings suggest that active involvement of patients and radiation oncologists, and surgeons in MDT care has boosted the probability of using local therapies for various types of OMD throughout the course of the disease.

show abstract

The impact of a multispecialty operative team on colorectal cancer surgery: A retrospective study from a would-be medical center in Taiwan

Chen

Chuang

et al. 2022

Medicine

View full text Add to dashboard Cite

Some studies showed that when distant metastasis or locally advanced tumors were observed, the participation of 2 or more operating surgeons (combined surgery) in the operation could improve the prognosis of patients. The multispecialty operative team would perform combined surgery in colon cancer patients with some complications since 2015.The goal of this study is to confirm performing combined surgery would improve the outcomes of colon cancer patients.A retrospective observational study was conducted, which involved all colon cancer patients between November 2015 and December 2019 at one would-be medical center. Patients were divided into 3 cohorts: those with complicated cases and had combined surgery (C_2S), those with complicated cases and had surgery performed by a single surgeon (C_1S), and those with uncomplicated cases and had surgery performed by a single surgeon (NC_1S). Overall survival and disease-free survival were compared among the 3 groups.A total of 296 colon cancer patients during the study period. Among them, 35 were C_2S, 87 were C_1S, and 174 were NC_1S. Patients in the NC_1S group had significantly higher 12-, 24-, and 36-month OS rates compared to those in the C_1S group (P < .01). In contrast, there was no significant difference in overall survival among patients in the NC_1S and C_2S group (P =.15).The quality of surgery must be impact the prognosis, especially in the individual who was complicated case, the survival in patients who had surgery performed by multispecialty operative team would be improved.Abbreviations: C_1S = patients with complicated cases and had surgery performed by a single surgeon, C_2S = patients with complicated cases and had combined surgery, CRC = colorectal cancer, CI = confidence interval, CT = computed tomography, DFS = disease-free survival, ELN = examined lymph node, HR = hazard ratio, LOS = length of stay, mCRC = metastatic colorectal cancer, NC_1S = patients with uncomplicated cases and had surgery performed by a single surgeon, OS = overall survival, R0 = resection for cure, SD = standard deviation, TCRD = Taiwan Cancer Registry Database.

show abstract

Management of colon cancer patients: A comprehensive analysis of the absence of multidisciplinary team meetings in two French departments

Cited by 4 publications

References 17 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

Active involvement of patients, radiation oncologists, and surgeons in a multidisciplinary team approach: Guiding local therapy in recurrent, metastatic rectal cancer

The impact of a multispecialty operative team on colorectal cancer surgery: A retrospective study from a would-be medical center in Taiwan

Contact Info

Product

Resources

About