Evaluation of multidisciplinary team decisions in neuroendocrine neoplasms: Impact of expert centres.

Autor:	Zandee WT; Department of Internal Medicine, Sector of Endocrinology Erasmus MC, Rotterdam, The Netherlands.; Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Centre Groningen, The Netherlands., Merola E; Department of Medicine 1, Division of Endocrinology, Friedrich-Alexander University, Erlangen-Nuremberg, Erlangen, Germany.; Department of Gastroenterology, Azienda Provinciale Servizi Sanitari (APSS), Trento, Italy., Poczkaj K; Department of Endocrinology and Neuroendocrine Tumours, Medical University of Silesia, Katowice, Poland., de Mestier L; Department of Gastroenterology and Pancreatology, Beaujon Hospital (APHP) and Paris 7 University, Clichy, France., Klümpen HJ; Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., Geboes K; Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium., de Herder WW; Department of Internal Medicine, Sector of Endocrinology Erasmus MC, Rotterdam, The Netherlands., Munir A; Department of Endocrinology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Jazyk:	angličtina
Zdroj:	European journal of cancer care [Eur J Cancer Care (Engl)] 2022 Nov; Vol. 31 (6), pp. e13639. Date of Electronic Publication: 2022 Jun 23.
DOI:	10.1111/ecc.13639
Abstrakt:	Objective: To evaluate the impact of multidisciplinary team (MDT) meetings on the management of patients with neuroendocrine neoplasms (NENs). Methods: All newly referred gastro-entero-pancreatic (GEP)-NEN patients discussed from 1 April to 1 October 2017 in the MDT of seven European expert centres were prospectively included. The impact on patients' management was defined as a change in diagnosis, grade, stage or treatment. Results: A total of 292 patients were included, mainly small intestinal (siNENs) (32%) and pancreatic NENs (28%), with distant metastases in 51%. Patients had received prior surgery in 43% of cases and prior medical treatment in 32%. A significant change occurred in 61% of NENs: 7% changes in diagnosis, 8% in grade and 16% in stage. The MDT recommended a new treatment for 51% of patients, mainly surgery (9%) or somatostatin analogues (20%). A significant change was most frequently observed in patients with Stage IV disease (hazard ratio [HR] 3.6, 95% confidence interval [CI]: 1.9-6.9 vs. Stage I) and G2 NENs (vs. G1, HR 2.1 95% CI: 1.2-3.8). Conclusion: NEN-dedicated MDT discussion in expert centres yields significant management changes in over 60% of patients and thus represents the gold standard for the management of these patients. (© 2022 John Wiley & Sons Ltd.)
Databáze:	MEDLINE
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