The value of a dedicated multidisciplinary expert panel to assess treatment strategy in patients suffering from colorectal cancer liver metastases
| Autor: | M E de Swart, Geert Kazemier, B.M. Zonderhuis, J J A Joosten, A A van Zweeden, Tessa Hellingman, Martijn R. Meijerink, J W D de Waard, J.J. de Vries |
|---|---|
| Přispěvatelé: | Surgery, General practice, Radiology and nuclear medicine, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and quality of life, Internal medicine, Amsterdam Gastroenterology Endocrinology Metabolism |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer Intraclass correlation 030230 surgery Tertiary referral hospital Systemic therapy 03 medical and health sciences 0302 clinical medicine Multidisciplinary approach Physicians Humans Medicine In patient Aged Netherlands Retrospective Studies Aged 80 and over Patient Care Team business.industry General surgery Liver Neoplasms Middle Aged medicine.disease Inter-rater reliability Oncology 030220 oncology & carcinogenesis Treatment strategy Female Interdisciplinary Communication Surgery Colorectal Neoplasms business |
| Zdroj: | Surgical Oncology, 35, 412-417. Elsevier BV Hellingman, T, de Swart, M E, Joosten, J J A, Meijerink, M R, de Vries, J J J, de Waard, J W D, van Zweeden, A A, Zonderhuis, B M & Kazemier, G 2020, ' The value of a dedicated multidisciplinary expert panel to assess treatment strategy in patients suffering from colorectal cancer liver metastases ', Surgical Oncology, vol. 35, pp. 412-417 . https://doi.org/10.1016/j.suronc.2020.09.024 |
| ISSN: | 0960-7404 |
| Popis: | BACKGROUND: For patients with colorectal cancer liver metastases (CRLM), local treatment is the only treatment with curative intent. The majority of patients with CRLM are however evaluated in multidisciplinary teams of colorectal cancer specialists often lacking expertise in local treatment of liver tumors. The aim of this study was therefore to assess the value of a dedicated multidisciplinary panel consisting of hepatobiliary surgeons and interventional radiologists for patients suffering from liver-only CRLM.METHODS: Patients diagnosed with liver-only CRLM in 2016 were identified in a tertiary referral hospital, and two of the referring hospitals in the Netherlands. Diagnostic imaging was independently reviewed by a panel of four hepatobiliary surgeons and two interventional radiologists to re-evaluate treatment strategy retrospectively. If two or more panelists assessed all lesions eligible for resection and/or ablation, patients were deemed eligible for local treatment with curative intent. Interrater reliability between hepatobiliary surgeons was assessed through intraclass correlation coefficient (ICC) and weighted Cohen's kappa.RESULTS: Diagnostic imaging of 61 patients with liver-only metastases were reviewed. Local treatment strategies appeared feasible in 40/61 (65.6%) patients. Five out of 25 patients (20.0%) initially assigned to systemic therapy were deemed eligible for upfront local treatment with curative intent (p = 0.015). In this subgroup, interrater reliability between hepatobiliary surgeons was substantial (ICC: 0.704, 95% CI: 0.536-0.838, n = 25).CONCLUSION: Assessment of treatment strategy by a dedicated multidisciplinary panel including liver experts may result in an increased number of patients eligible for potentially curative treatment and reduce undertreatment of patients suffering from liver-only CRLM. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect