AI Article Synopsis

  • The study investigated how patient participation in multidisciplinary teams (MDT) affects the treatment of locally advanced rectal cancer, specifically focusing on the application of metastasis-directed local therapy.
  • Out of 1211 patients analyzed, a significant number were treated in an MDT clinic that required input from multiple experts and patients, leading to increased use of radiotherapy and local therapy sessions.
  • The results indicate that involving patients and specialists in MDT care improves the likelihood of utilizing effective local therapies for various states of metastasis throughout the treatment process.

Article Abstract

Background: Despite the extensive implementation of an organized multidisciplinary team (MDT) approach in cancer treatment, there is little evidence regarding the optimal format of MDT. We aimed to investigate the impact of patient participation in MDT care on the actual application rate of metastasis-directed local therapy.

Methods: We identified all 1211 patients with locally advanced rectal cancer treated with neoadjuvant radiochemotherapy at a single institution from 2006 to 2018. Practice patterns, tumor burden and OMD state were analyzed in recurrent, metastatic cases.

Results: With a median follow-up of 60.7 months, 281 patients developed metastases, and 96 (34.2%), 92 (32.7%), and 93 (33.1%) patients had 1, 2-5, and >5 lesions, respectively. In our study, 27.1% were managed in the MDT clinic that mandated the participation of at least four to five board-certified multidisciplinary experts and patients in decision-making processes, while the rest were managed through diverse MDT approaches such as conferences, tumor board meetings, and discussions conducted via phone calls or email. Management in MDT clinic was significantly associated with more use of radiotherapy (p = 0.003) and more sessions of local therapy (p < 0.001). At the time of MDT clinic, the number of lesions was 1, 2-5, and >5 in 9 (13.6%), 35 (53.1%), and 19 (28.8%) patients, respectively. The most common states were repeat OMD (28.8%) and de novo OMD (27.3%), followed by oligoprogression (15%) and induced OMD (10.6%).

Conclusion: Our findings suggest that active involvement of patients and radiation oncologists, and surgeons in MDT care has boosted the probability of using local therapies for various types of OMD throughout the course of the disease.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10709736PMC
http://dx.doi.org/10.1002/cam4.6667DOI Listing

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