The impact of the multidisciplinary tumor board (MDTB) on the management of pancreatic diseases in a tertiary referral center
| Autor: | Frediano Inzani, Claudio Fiorillo, E. Genco, V. Valentini, Antonio Gasbarrini, Giampaolo Tortora, Cinzia Bagalà, Marta Ribelli, L. Zileri, Francesca D'Aversa, Fabia Attili, Giuseppe Quero, M.G. Maratta, Vincenzo Perri, Federica Galiandro, B. Di Stefano, Caterina Cina, Sergio Alfieri, Guido Costamagna, G.C. Mattiucci, Roberta Menghi, Alberto Larghi, Lisa Salvatore, Berterame Nadia Maria, Brizi Mg, Riccardo Manfredi, Vito Laterza |
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| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Settore MED/18 - CHIRURGIA GENERALE pancreatic cancer Interdisciplinary Studies Tumor response Tertiary Care Centers resectability assessment Multidisciplinary approach Pancreatic cancer medicine Humans Tumor board Medical diagnosis Original Research tumor response business.industry Pancreatic Diseases medicine.disease pancreatic disease management Pancreatic Neoplasms Oncology Treatment strategy Referral center Radiology business multidisciplinary tumor board |
| Zdroj: | ESMO Open |
| ISSN: | 2059-7029 |
| Popis: | Background The implementation of multidisciplinary tumor board (MDTB) meetings significantly ameliorated the management of oncological diseases. However, few evidences are currently present on their impact on pancreatic cancer (PC) management. The aim of this study was to evaluate the impact of the MDTB on PC diagnosis, resectability and tumor response to oncological treatment compared with indications before discussion. Patients and methods All patients with a suspected or proven diagnosis of PC presented at the MDTB from 2017 to 2019 were included in the study. Changes of diagnosis, resectability and tumor response to oncological/radiation treatment between pre- and post-MDTB discussion were analyzed. Results A total of 438 cases were included in the study: 249 (56.8%) were presented as new diagnoses, 148 (33.8%) for resectability assessment and 41 (9.4%) for tumor response evaluation to oncological treatment. MDTB discussion led to a change in diagnosis in 54/249 cases (21.7%), with a consequent treatment strategy variation in 36 cases (14.5%). Change in resectability was documented in 44/148 cases (29.7%), with the highest discrepancy for borderline lesions. The treatment strategy was thus modified in 27 patients (18.2%). The MDTB brought a modification in the tumor response assessment in 6/41 cases (14.6%), with a consequent protocol modification in four (9.8%) cases. Conclusions MDTB discussion significantly impacts on PC management, especially in high-volume centers, with consistent variations in terms of diagnosis, resectability and tumor response assessment compared with indications before discussion. Highlights • Few evidences are present on the impact of the multidisciplinary tumor board (MDTB) on pancreatic cancer (PC) management • We documented a discrepancy rate of 23.7% between the pre- and post-MDTB discussion. • This underlines the fundamental role of the MDTB in PC management. |
| Databáze: | OpenAIRE |
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