Multidisciplinary team intervention associated with improved survival for patients with colorectal adenocarcinoma with liver or lung metastasis.

Autor:	Chen CH; Department of Colorectal Surgery, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan., Hsieh MC; Department of General Surgery, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan., Lao WT; Department of Radiology, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan., Lin EK; Department of Colorectal Surgery, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan., Lu YJ; Department of Colorectal Surgery, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan., Wu SY; Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan.; Institute of Clinical Science, Zhongshan Hospital, Fudan University Shanghai 200032, China.; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	American journal of cancer research [Am J Cancer Res] 2018 Sep 01; Vol. 8 (9), pp. 1887-1898. Date of Electronic Publication: 2018 Sep 01 (Print Publication: 2018).
Abstrakt:	Background and Objectives: To investigate whether multidisciplinary team (MDT) intervention is associated with improved survival for patients with colorectal adenocarcinoma with liver or lung metastasis (CRA-LLM). Methods: We enrolled 161 consecutive patients with histologically confirmed CRA-LLM at Taipei Medical University-Wan Fang Hospital between January 2007 and December 2017. In total, 75 patients with CRA-LLM received MDT intervention, and 86 patients did not receive MDT intervention. To evaluate prognostic factors for overall death, we performed univariate and multivariate Cox regression analyses of the overall death rate in all patients. Overall survival rates were calculated using the Kaplan-Meier method, and Kaplan-Meier survival curves were compared using the log-rank test ( P < .001). Results: A multivariate Cox regression analysis of the overall death rate in patients with CRA-LLM showed that age ≤ 65 years, systemic chemotherapy, curative-intent treatments, and MDT intervention are strong prognostic factors. The adjusted hazard ratio of death risk for age ≤ 65 years, systemic chemotherapy, curative-intent treatments, and MDT intervention were 0.60 (95% confidence interval [CI], 0.40-0.92; P = .019), 0.19 (95% CI, 0.12-0.32; P = .001), 0.25 (95% CI, 0.13-0.50; P = .001), and 0.40 (95% CI, 0.25-0.65; P = .001), respectively. The 3-year overall survival rates in patients with CRA-LLM receiving MDT intervention and not receiving MDT intervention were 48.75% and 24.21%, respectively. Conclusion: MDT intervention is associated with improved survival for patients with CRA-LLM. Competing Interests: None.
Databáze:	MEDLINE
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