中华医学杂志（英文版）2012，Vol.125Issue(2)：172-177,6.DOI:10.3760/cma.j.issn.0366-6999.2012.02.002
Impact of multidisciplinary team working on the management of colorectal cancer
Impact of multidisciplinary team working on the management of colorectal cancer
YE Ying-jiang 1G. J. Poston 2WANG Shan 1SHEN Zhan-long 1SUN Xian-tao 3WANG Zhi-feng 1SHEN Dan-hua 4LIU Hui-jun 5ZHANG Wan-lei 6CHEN Ya-lin 7ZHOU Jing8
作者信息
- 1. Department of Gastroenterological Surgery,Peking University People's Hospital, Beijing 100044, China
- 2. Department of Surgery, University Hospital Aintree, Liverpool L97AL, UK
- 3. Department of Surgical Oncology,Peking University People's Hospital, Beijing 100044, China
- 4. Department of Gastroenterology,Peking University People's Hospital, Beijing 100044, China
- 5. Department of Pathology, Peking University People's Hospital, Beijing 100044, China
- 6. Department of Radiology,Peking University People's Hospital, Beijing 100044, China
- 7. Department of Ultrasonics, Peking University People's Hospital, Beijing 100044, China
- 8. Department of Radiotherapy, Peking University People's Hospital, Beijing 100044, China
- 折叠
摘要
Abstract
Background The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline.Colorectal cancer multidisciplinary team (MDT) working model is recommended by UK and other countries,but there is little information on the impact of MDT working on management of colorectal cancer in China.The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.Methods A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery,the pre-MDT cohort include 297 patients,recruited from January 1999 to November 2002,and the MDT cohort had 298 patients enrolled from December 2002 to September 2006.Information recorded included:TNM stage from histological reports,degree of differentiation,the number of examined lymph nodes and CT TNM staging performed or not,and its accuracy,including local and distant recurrence.Results The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group.CT TNM staging was more accurate in the MDT group compared to the pre-MDT group (P=-0.044).The rate of tumor recurrence in the MDT group was lower than pre-MDT group (log-rank test,P ＜0.001).Multivariate analysis revealed that age (P=0.001),management after inception of the MDT (P=0.002),degree of differentiation (P=0.003),number of examined lymph nodes (P=0.002),and TNM stage (P=0.000) were important factors that independently influence overall survival.Conclusions The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients.MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis,evidence-based decision making,and optimal treatment planning.关键词
colorectal cancer/TNM stages/computed tomography/overall survival/liver metastases/multidisciplinary team/chemotherapy/surgeryKey words
colorectal cancer/TNM stages/computed tomography/overall survival/liver metastases/multidisciplinary team/chemotherapy/surgery引用本文复制引用
YE Ying-jiang,G. J. Poston,WANG Shan,SHEN Zhan-long,SUN Xian-tao,WANG Zhi-feng,SHEN Dan-hua,LIU Hui-jun,ZHANG Wan-lei,CHEN Ya-lin,ZHOU Jing..Impact of multidisciplinary team working on the management of colorectal cancer[J].中华医学杂志（英文版）,2012,125(2):172-177,6.
