Impact of multidisciplinary tumor board discussion on palliation of patients with esophageal or gastro-esophageal junction cancer: a population-based study
| Autor: | Ruud W. M. Schrauwen, Adriaan C.I.T.L. Tan, M. J.M. Groenen, Robert C.H. Scheffer, Bram D. Vermeulen, Dirk Jan Bac, Peter D. Siersema, Rob H.A. Verhoeven, Ludger S. M. Epping, Lukas Bruggeman |
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| Přispěvatelé: | Oncology, CCA - Cancer Treatment and Quality of Life, APH - Methodology, APH - Quality of Care, Internal medicine |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Palliative care Esophageal Neoplasms medicine.medical_treatment Population 030218 nuclear medicine & medical imaging 03 medical and health sciences Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 0302 clinical medicine Stomach Neoplasms Internal medicine Medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy education Survival rate Aged Netherlands Patient Care Team education.field_of_study Chemotherapy business.industry Palliative Care Cancer Hematology General Medicine Esophageal cancer medicine.disease Prognosis Combined Modality Therapy Cancer registry Survival Rate Oncology 030220 oncology & carcinogenesis Female Interdisciplinary Communication Esophagogastric Junction business |
| Zdroj: | Acta Oncologica, 59, 4, pp. 410-416 Acta Oncologica, 59, 410-416 Acta Oncologica, 59(4), 410-416. Informa Healthcare Vermeulen, B D, Bruggeman, L, Bac, D J, Schrauwen, R W M, Epping, L S M, Scheffer, R C H, Tan, A C I T L, Groenen, M J M, Verhoeven, R H A & Siersema, P D 2020, ' Impact of multidisciplinary tumor board discussion on palliation of patients with esophageal or gastro-esophageal junction cancer: a population-based study ', Acta Oncologica, vol. 59, no. 4, pp. 410-416 . https://doi.org/10.1080/0284186X.2020.1725240 |
| ISSN: | 1651-226X 0284-186X |
| Popis: | Contains fulltext : 220092.pdf (Publisher’s version ) (Open Access) Background: The Dutch guidelines for esophageal and gastro-esophageal junction (GEJ) cancer recommend discussion of patients by a multidisciplinary tumor board (MDT). Despite this recommendation, one previous study in the Netherlands suggested that therapeutic guidance was missing for palliative care of patients with esophageal cancer. The aim of the current study was therefore to assess the impact of an MDT discussion on initial palliative treatment and outcome of patients with esophageal or GEJ cancer.Material and methods: The population-based Netherlands Cancer Registry was used to identify patients treated for esophageal or GEJ cancer with palliative intent between 2010 and 2017 in 7 hospitals. We compared patients discussed by the MDT with patients not discussed by the MDT in a multivariate analysis. Primary outcome was type of initial palliative treatment. Secondary outcome was overall survival.Results: A total of 389/948 (41%) patients with esophageal or GEJ cancer were discussed by the MDT before initial palliative treatment. MDT discussion compared to non-MDT discussion was associated with more patients treated with palliative intent external beam radiotherapy (38% vs. 21%, OR 2.7 [95% CI 1.8-3.9]) and systemic therapy (30% vs. 23%, OR 1.6 [95% CI 1.0-2.5]), and fewer patients treated with stent placement (4% vs. 12%, OR 0.3 [95% CI 0.1-0.6]) and best supportive care alone (12% vs. 33%, OR 0.2 [95% CI 0.1-0.3]). MDT discussion was also associated with improved survival (169 days vs. 107 days, HR 1.3 [95% CI 1.1-1.6]).Conclusion: Our study shows that MDT discussion of patients with esophageal or GEJ cancer resulted in more patients treated with initial palliative radiotherapy and chemotherapy compared with patients not discussed by the MDT. Moreover, MDT discussion may have a positive effect on survival, highlighting the importance of MDT meetings at all stages of treatment. |
| Databáze: | OpenAIRE |
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