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Lindblad M, Jestin C, Johansson J, Edholm D, Linder G. Multidisciplinary team meetings improve survival in patients with esophageal cancer. Dis Esophagus 2024:doae061. [PMID: 39119871 DOI: 10.1093/dote/doae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/27/2024] [Accepted: 08/02/2024] [Indexed: 08/10/2024]
Abstract
Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs' effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan-Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80-90 years; odds ratio [OR] 0.25, 0.16-0.42 (95% confidence interval)) and clinical stage IVb (OR 0.65, 0.43-0.98) decreased the probability of being presented at an MDT, whereas high education level (OR 1.31, 1.02-1.67), being married (OR 1.20, 1.01-1.43), squamous histology (OR 1.50, 1.22-1.84) and later year of diagnosis (OR 1.33, 1.29-1.37 per year) increased the probability of an MDT. In multivariable adjusted analysis, MDT discussion was associated with improved survival (hazard ratios 0.72, 0.66-0.78) and median survival increased from 4.5 to 10.7 months. MDTs were associated with improved survival for esophageal cancer patients. Elderly patients with advanced disease and poor socioeconomic status were less likely to be presented at an MDT, but had clear survival-benefits if they were discussed in a multidisciplinary setting.
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Affiliation(s)
- Mats Lindblad
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - Christine Jestin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Jan Johansson
- Department of Surgery, Lund University, Lund, Sweden
| | - David Edholm
- Department of Surgery, Linköping University, Linköping, Sweden
| | - Gustav Linder
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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Tortorello GN, Shafique N, Keele L, Susman CG, Dheer A, Fayanju OM, Tchou J, Miura JT, Karakousis GC. Longitudinal Increases in Time to Surgery for Patients with Breast Cancer: A National Cohort Study. Ann Surg Oncol 2024:10.1245/s10434-024-15723-w. [PMID: 39003381 DOI: 10.1245/s10434-024-15723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/19/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Longer time to surgery (TTS) is associated with worse survival in patients with breast cancer. Whether this association has encouraged more prompt care delivery remains unknown. METHODS The National Cancer Database was used to identify patients ≥18 years of age diagnosed with clinical stage 0-III breast cancer between 2006 and 2019 for whom surgery was the first mode of treatment. A linear-by-linear test for trend assessed median TTS across the interval. Adjusted linear regression modeling was used to examine TTS trends across patient subgroups. RESULTS Overall, 1,435,584 patients met the inclusion criteria. The median age was 63 years (interquartile range [IQR] 53-72), 84.3% of patients were White, 91.1% were non-Hispanic, and 99.2% were female. The median TTS in 2006 was 26 days (IQR 16-39) versus 39 days in 2019 (IQR 27-56) [p < 0.001]. In a multivariable linear regression model, TTS increased significantly, with an annual increase of 0.83 days (95% confidence interval 0.82-0.85; p < 0.001). A consistent, significant increase in TTS was observed on subgroup analyses by surgery type, reconstruction, patient race, hospital type, and disease stage. Black race, Hispanic ethnicity, and having either Medicaid or being uninsured were significantly associated with prolonged TTS, as were mastectomy and reconstructive surgery. CONCLUSIONS Despite evidence that longer TTS is associated with poorer outcomes in patients with breast cancer, TTS has steadily increased, which may be particularly detrimental to marginalized patients. Further studies are needed to ensure the delivery of timely care to all patients.
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Affiliation(s)
- Gabriella N Tortorello
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - Neha Shafique
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Luke Keele
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Carolyn G Susman
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anushka Dheer
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Julia Tchou
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - John T Miura
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Giorgos C Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Li L, Yu J, Shen K, Chen X. The 21-Gene Recurrence Score Assay Improved Multidisciplinary Treatment Compliance in Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer Patients: An Analysis of 2,323 Patients. J Breast Cancer 2024; 27:163-175. [PMID: 38769684 PMCID: PMC11221206 DOI: 10.4048/jbc.2023.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/28/2024] [Accepted: 03/24/2024] [Indexed: 05/22/2024] Open
Abstract
PURPOSE The 21-gene recurrence score (RS) can guide adjuvant chemotherapy decisions in the multidisciplinary treatment (MDT) of patients with early breast cancer. This study aimed to evaluate the influence of the 21-gene RS assay on patient' compliance with MDT and its association with disease outcomes. METHODS Patients diagnosed with pN0-1, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer between January 2013 and June 2019 were enrolled. A logistic regression model was used to identify parameters associated with treatment adherence. Prognostic indicators were evaluated using the Cox proportional hazard models. RESULTS After the assay, patients were less likely to violate the treatment plan (14.9% vs. 23.1%, p < 0.001), and higher compliance rates were observed for chemotherapy (p = 0.042), radiotherapy (p = 0.012), and endocrine therapy (p < 0.001). Multivariable analysis demonstrated that the 21-gene RS assay (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.09-1.88; p = 0.009) was independently associated with MDT compliance. Moreover, compliance with MDT was independently associated with better disease-free survival (hazard ratio, 0.43; 95% CI, 0.29-0.64; p < 0.001), regardless of the 21-gene RS assay (interaction p = 0.842). CONCLUSION The 21-gene RS assay improved the MDT compliance rate in patients with early breast cancer. Adherence to MDT is associated with a better prognosis.
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Affiliation(s)
- Liangqiang Li
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Breast Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, China
| | - Jing Yu
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kunwei Shen
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaosong Chen
- Department of General Surgery, Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Reyes-Monasterio A, Möller MG, Lozada-Martinez ID, Narvaez-Rojas AR, De la Cruz Ku G, Metke R, Cabrera-Vargas LF, Torregrosa-Almonacid L, Lesmes LC, Eli A, Paulinelli RR. Bridging frontiers: The role of a Global Breast Research Working Group. J Surg Oncol 2024; 129:1507-1514. [PMID: 38685712 DOI: 10.1002/jso.27660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
Breast cancer remains a significant cause of death for women globally, despite advancements in detection and treatment, low- and middle-income countries face unique obstacles. Role of Research Working Group (RWG) can expedite research progress by fostering collaboration between scientists, clinicians, and stakeholders. Benefits of a Global RWG include pooling resources and expertise to develop new research ideas, addressing disparities, and building local research capacity, with the potential to improve breast cancer research and outcomes.
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Affiliation(s)
- Antonio Reyes-Monasterio
- Universidad Nacional Experimental Francisco de Miranda, Coro, Venezuela
- Global Breast Research Working Group, Miami, USA
| | - Mecker Geraldine Möller
- Global Breast Research Working Group, Miami, USA
- DeWitt-Department of Surgery, Division of Surgical Oncology, Leonard M. Miller School of Medicine/Jackson Health System, University of Miami, Miami, Florida, USA
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA
| | - Ivan David Lozada-Martinez
- Global Breast Research Working Group, Miami, USA
- Department of Graduate Studies in Health Sciences, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | - Alexis Rafael Narvaez-Rojas
- Global Breast Research Working Group, Miami, USA
- DeWitt-Department of Surgery, Division of Surgical Oncology, Leonard M. Miller School of Medicine/Jackson Health System, University of Miami, Miami, Florida, USA
- International Coalition on Surgical Research, Universidad Nacional Autónoma de Nicaragua, Managua, Nicaragua
| | - Gabriel De la Cruz Ku
- Global Breast Research Working Group, Miami, USA
- Universidad Científica del Sur, Lima, Perú
| | - Ricardo Metke
- Global Breast Research Working Group, Miami, USA
- Department of General Surgery, School of Medicine, Universidad Javeriana de Bogotá, Bogotá, Colombia
| | - Luis Felipe Cabrera-Vargas
- Global Breast Research Working Group, Miami, USA
- Department of Surgery, Fundación Santa Fe de Bogotá, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Lilian Torregrosa-Almonacid
- Global Breast Research Working Group, Miami, USA
- Department of General Surgery, School of Medicine, Universidad Javeriana de Bogotá, Bogotá, Colombia
| | | | - Avisar Eli
- Global Breast Research Working Group, Miami, USA
- DeWitt-Department of Surgery, Division of Surgical Oncology, Leonard M. Miller School of Medicine/Jackson Health System, University of Miami, Miami, Florida, USA
| | - Regis Resende Paulinelli
- Global Breast Research Working Group, Miami, USA
- Araujo Jorge Cancer Hospital, Albert Einstein Israeli Hospital Goiania, Federal University of Goias, Goiânia, Brazil
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Al-Shamsi HO, Alwbari A, Azribi F, Calaud F, Thuruthel S, Tirmazy SHH, Kullab S, Ostomane S, Abulkhair O. BRCA testing and management of BRCA-mutated early-stage breast cancer: a comprehensive statement by expert group from GCC region. Front Oncol 2024; 14:1358982. [PMID: 38725624 PMCID: PMC11080009 DOI: 10.3389/fonc.2024.1358982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/28/2024] [Indexed: 05/12/2024] Open
Abstract
BReast CAncer (BRCA)1 and BRCA2 gene pathogenic variants account for most hereditary breast cancers (BC). Identification of BRCA mutations can significantly influence both prognosis and treatment outcomes. Furthermore, it enables the identification of individuals who are at heightened risk of developing BC due to inherited genetic mutations. Many developing countries rely on western guidelines for BRCA testing and BC management; however, there exist wide disparities in the prevalence of risk factors, availability of medical resources, and practice patterns. Guidelines tailored to specific regions can help mitigate healthcare variations, promote consistency in treatment, and aid healthcare providers in identifying effective therapies for improving patient outcomes. Hence, oncologists from the Gulf Cooperation Council (GCC) congregated virtually in March 2023 and reviewed existing data on the epidemiology of BC, BRCA mutations, practices and challenges associated with BRCA testing and management of BRCA mutated early-stage BC in the GCC region. They also provided insights on the real-world diagnostic and treatment practices and challenges in the GCC region in the BRCA-mutated early-stage BC domain and suggested some variations to international guidelines to aid their uptake in this region.
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Affiliation(s)
- Humaid O. Al-Shamsi
- Burjeel Medical City, Burjeel Holding, Abu Dhabi, United Arab Emirates
- Gulf Medical University, Ajman, United Arab Emirates
- Emirates Oncology Society, Dubai, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Gulf Cancer Society, Alsafa, Kuwait
| | - Ahmed Alwbari
- Almoosa Specialist Hospital Cancer Center, Al Ahsa, Saudi Arabia
| | | | | | | | | | - Sharif Kullab
- King Khalid University Hospital, Riyadh, Saudi Arabia
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Huang RS, Mihalache A, Nafees A, Hasan A, Ye XY, Liu Z, Leighl NB, Raman S. The impact of multidisciplinary cancer conferences on overall survival: a meta-analysis. J Natl Cancer Inst 2024; 116:356-369. [PMID: 38123515 DOI: 10.1093/jnci/djad268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Multidisciplinary cancer conferences consist of regular meetings between diverse specialists working together to share clinical decision making in cancer care. The aim of this study was to systematically review and meta-analyze the effect of multidisciplinary cancer conference intervention on the overall survival of patients with cancer. METHODS A systematic literature search was conducted on Ovid MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials for studies published up to July 2023. Studies reporting on the impact of multidisciplinary cancer conferences on patient overall survival were included. A standard random-effects model with the inverse variance-weighted approach was used to estimate the pooled hazard ratio of mortality (multidisciplinary cancer conference vs non-multidisciplinary cancer conference) across studies, and the heterogeneity was assessed by I2. Publication bias was examined using funnel plots and the Egger test. RESULTS A total of 134 287 patients with cancer from 59 studies were included in our analysis, with 48 467 managed by multidisciplinary cancer conferences and 85 820 in the control arm. Across all cancer types, patients managed by multidisciplinary cancer conferences had an increased overall survival compared with control patients (hazard ratio = 0.67, 95% confidence interval = 0.62 to 0.71, I2 = 84%). Median survival time was 30.2 months in the multidisciplinary cancer conference group and 19.0 months in the control group. In subgroup analysis, a positive effect of the multidisciplinary cancer conference intervention on overall survival was found in breast, colorectal, esophageal, hematologic, hepatocellular, lung, pancreatic, and head and neck cancer. CONCLUSIONS Overall, our meta-analysis found a significant positive effect of multidisciplinary cancer conferences compared with controls. Further studies are needed to establish nuanced guidelines when optimizing multidisciplinary cancer conference integration for treating diverse patient populations.
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Affiliation(s)
- Ryan S Huang
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrew Mihalache
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Asad Hasan
- University of British Columbia, Vancouver, BC, Canada
| | - Xiang Y Ye
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Zhihui Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Natasha B Leighl
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Srinivas Raman
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
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Law NLW, Hong LW, Tan SSN, Foo CJ, Lee D, Voon PJ. Barriers And Challenges Of Multidisciplinary Teams In Oncology Management: A Scoping Review Protocol. BMJ Open 2024; 14:e079559. [PMID: 38341218 PMCID: PMC10862282 DOI: 10.1136/bmjopen-2023-079559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Multidisciplinary teams (MDTs) are integral to oncology management, involving specialised healthcare professionals who collaborate to develop individualised treatment plans for patients. However, as cancer care grows more complex, MDTs must continually adapt to better address patient needs. This scoping review will explore barriers and challenges MDTs have encountered in the past decade; and propose strategies for optimising their utilisation to overcome these obstacles and improve patient care. METHODS AND ANALYSIS The scoping review will follow Arksey and O'Malley's framework and begin with a literature search using keywords in electronic databases such as PubMed/MEDLINE, Scopus and PsychINFO, covering the period from January 2013 to December 2022 and limited to English language publications. Four independent reviewers will screen titles and abstracts based on predefined inclusion criteria, followed by full-text review of selected titles. Relevant references cited in the publications will also be examined. A Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram will be utilised to illustrate the methodology. Data from selected publications will be extracted, analysed, and categorised for further analysis. ETHICS AND DISSEMINATION The results of the scoping review will provide a comprehensive overview of the barriers and challenges encountered by oncology MDTs over the past decade. These findings will contribute to the existing literature and provide insights into areas that require improvement in the functioning of MDTs in oncology management. The results will be disseminated through publication in a scientific journal, which will help to share the findings with the wider healthcare community and facilitate further research and discussion in this field. TRIAL REGISTRATION DETAILS The protocol for this scoping review is registered with Open Science Framework, available at DOI 10.17605/OSF.IO/R3Y8U.
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Affiliation(s)
- Nicholas Lee Wei Law
- Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Lai Wei Hong
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Shirley Siang Ning Tan
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
- Department of Pharmacy, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Chuan Jie Foo
- Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Daniel Lee
- Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Pei Jye Voon
- Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Ministry of Health Malaysia, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
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Cloconi C, Georgiou C, Zamba N, Zamboglou C, Ferentinos K. Use of Radiotherapy in Advanced Breast Cancer: The Role of a Nurse. Semin Oncol Nurs 2024; 40:151567. [PMID: 38097413 DOI: 10.1016/j.soncn.2023.151567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES Systemic therapy is the mainstay in advanced breast cancer (ABC), but innovations in radiation oncology have given radiotherapy a crucial role in the treatment of both intracranial and extracranial ABC. Breast cancer specialists include, in addition to medical and clinical oncologists, breast cancer nurses with unique theoretical knowledge and significant clinical experience. This review aims to discuss the function of radiotherapy in ABC and to highlight the role and importance of specialized nursing care for ABC patients receiving radiotherapy. DATA SOURCES An extensive literature review was conducted on the role of radiotherapy and its implementation in various settings of ABC and the pivotal contribution of nursing practices to the quality of life of these patients, with a particular focus on symptom and side effect management and prevention, education, as well as unmet patient needs. The Advanced Breast Cancer International Consensus Guidelines (ABC-5) were also included. All the above data were combined with the expert and practical considerations of breast cancer specialists within the team. CONCLUSION The sophisticated application of radiotherapy and the complexity of ABC patient management, concerning symptoms, side effects, and overall well-being necessitate collaborative efforts to optimize patient care. Breast cancer nurses hold a central role in this framework. IMPLICATIONS FOR NURSING PRACTICE The significance of specialized nursing in contributing to comprehensive patient care for ABC patients treated with radiotherapy outlines the need for extensive training that aims to provide a holistic approach and entails physical, mental, and emotional support and patient and caregiver education.
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Affiliation(s)
- Constantina Cloconi
- Head Nurse/Research Nurse of Radiation Oncology Department, German Oncology Center and Cyprus University of Technology, Limassol, Cyprus
| | - Christina Georgiou
- Nurse of Radiation Oncology Department, German Oncology Center and Cyprus University of Technology, Limassol, Cyprus
| | - Nicole Zamba
- Junior Doctor of Radiation Oncology Department, German Oncology Center, Limassol, Cyprus.
| | | | - Konstantinos Ferentinos
- Director of Radiation Oncology Department, German Oncology Center, Limassol, and European University of Cyprus, Nicosia, Cyprus
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Tseng YC, Kung PT, Peng CY, Chou WY, Tsai WC. Effect of multidisciplinary team care on patient survival in chronic hepatitis B or C hepatocellular carcinoma. Front Oncol 2023; 13:1251571. [PMID: 38179172 PMCID: PMC10764426 DOI: 10.3389/fonc.2023.1251571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/31/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Multidisciplinary team care coordinates with medical teams to improve the quality of cancer care. This study explored multidisciplinary team care in hepatitis B or hepatitis C virus-related hepatocellular carcinoma patients from the time of diagnosis to the first-time treatment interval and investigated treatment outcomes and prognosis. Methods This retrospective cohort study included data from a nationwide population from 2007 to 2016. Data were collected from the Taiwan Cancer Registry Database, linked to the Taiwan National Health Insurance Research Database. Propensity score matching was applied at a ratio of 1:2 to reduce the selection bias. A multiple regression model with generalized estimating equations was used to analyze whether multidisciplinary team care affected the diagnosis-to-treatment interval. The stratified Cox proportional hazards model examined whether involvement in multidisciplinary team care influenced survival status. Results A total of 10,928 and 21,856 patients with hepatocellular carcinoma received multidisciplinary and non-multidisciplinary care, respectively. Participants with multidisciplinary care had a longer diagnosis-to-treatment interval but a lower risk of cumulative cancer death (HR=0.88, 95% CI:0.84-0.92). In patients with intermediate- to advanced-stage hepatocellular carcinoma, multidisciplinary team care has obvious benefits for improving survival. Conclusion Patients with hepatocellular carcinoma who participated in multidisciplinary team care had a longer diagnosis-to-treatment interval but a lower risk of cancer death. Patients with intermediate- to advanced-stage hepatocellular carcinoma who received multidisciplinary team care significantly benefited from this outcome. Hospitals should provide HCC patients with multidisciplinary team care to improve cancer care.
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Affiliation(s)
- Yu-Chen Tseng
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Yuan Peng
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Yu Chou
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
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Pangarsa EA, Rizky D, Tandarto K, Setiawan B, Santosa D, Hadiyanto JN, Kyana S, Suharti C. The effect of multidisciplinary team on survival rates of women with breast cancer: a systematic review and meta-analysis. Ann Med Surg (Lond) 2023; 85:2940-2948. [PMID: 37363480 PMCID: PMC10289736 DOI: 10.1097/ms9.0000000000000914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/14/2023] [Indexed: 06/28/2023] Open
Abstract
Breast cancer is quite frequent all around the world. This disease was responsible for an estimated 2.1 million malignancies in 2022, making it the seventh-highest cause of cancer deaths globally. A multidisciplinary team (MDT) care policy was developed in the United Kingdom (UK) in 1995 to enhance the quality of care for cancer patients. The purpose of this systematic review and meta-analysis study is to assess the effects of MDT on breast cancer survival rates. Methods This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Systematic search was conducted in several international databases including Google Scholar, PubMed, EBSCOhost, and Proquest from 2012 to 2022. The authors used RevMan 5.4 to do the meta-analysis of the pooled hazard ratio. Newcastle-Ottawa Scale to measure the risk of bias. Newcastle-Ottawa Scale evaluated participant selection, comparability, and reporting of results using eight subscale items. Egger's test funnel plot was used to assess the potential publication bias for this study. Results A total of 1187 studies were identified from research database. The authors found a total of six studies from six different countries (China, the UK, Taiwan, Australia, Africa, and France) included for this study. Based on the meta-analysis of the pooled hazard ratio of the included studies, the authors found that the overall effect size of the study was 0.80 (CI 95%: 0.73-0.88). Conclusions Breast cancer patients who participated in well-organized MDT discussions had a greater survival rate than those who did not.
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Affiliation(s)
- Eko A. Pangarsa
- Hematology Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital Semarang, Indonesia
| | - Daniel Rizky
- Hematology Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital Semarang, Indonesia
| | - Kevin Tandarto
- Hematology Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital Semarang, Indonesia
| | - Budi Setiawan
- Hematology Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital Semarang, Indonesia
| | - Damai Santosa
- Hematology Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital Semarang, Indonesia
| | - Jessica N. Hadiyanto
- Department of Internal Medicine, Dr. Kariadi General Hospital/Faculty of Medicine, Diponegoro University, Indonesia
| | - Salma Kyana
- Department of Internal Medicine, Dr. Kariadi General Hospital/Faculty of Medicine, Diponegoro University, Indonesia
| | - Catharina Suharti
- Hematology Medical Oncology Division, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital Semarang, Indonesia
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Strönisch A, Märdian S, Flörcken A. Centralized and Interdisciplinary Therapy Management in the Treatment of Sarcomas. Life (Basel) 2023; 13:life13040979. [PMID: 37109507 PMCID: PMC10144040 DOI: 10.3390/life13040979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Sarcoma treatment requires a high level of expertise due to its rarity and heterogeneity. Sarcoma patients should, therefore, be referred to an expert centre as early as possible to ensure optimal treatment. Numerous studies have been carried out to provide evidence for this strategy. In compliance with the 2020 PRISMA guidelines, a systematic search was conducted in PubMed, EMBASE, Ovid Medline, ClinicalTrials.gov and Cochrane Library databases. The subject of these studies was the centralised treatment of adult sarcoma patients at expert centres and the use of interdisciplinary tumour boards. Uncertainty in therapy, delays in referral to expert centres, and limited access to therapeutic modalities continue to be a challenge in sarcoma therapy. At expert centres, diagnostic procedures were more frequently and adequately performed, and treatment was associated with an improvement in outcomes in the majority of studies: patients benefited from longer survival, lower local recurrence rates and a better postoperative outcome. The implementation of an interdisciplinary tumour board was associated with discrepant results. In a greater number of studies, it was associated with a lower local relapse rate, better overall survival and surgical outcome. In two studies, however, a shorter overall survival was observed. The establishment of expert centres and the consistent use of interdisciplinary tumour boards are important structures for ensuring multidisciplinary therapy approaches. There is growing evidence that this holds great potential for optimising sarcoma therapy.
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Affiliation(s)
- Annika Strönisch
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Sven Märdian
- Centre for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
| | - Anne Flörcken
- Department of Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
- Charité-Universitätsmedizin Berlin, German Cancer Consortium (DKTK), Partner Site Berlin, and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Licata L, Cosentini D, De Sanctis R, Iorfida M, Caremoli ER, Vingiani A, Simoncini EL, Pruneri G, Munzone E, Bianchini G, Zambelli A, Tondini C. Multigene signatures for early breast cancer in clinical practice: A report of the Lombardy genomic assays for breast cancer working group. Front Oncol 2023; 13:1081885. [PMID: 36950554 PMCID: PMC10025563 DOI: 10.3389/fonc.2023.1081885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
The increasing understanding of breast cancer biology has provided the basis for the development of multigene signatures aimed to improve the capability of clinicians to assess patients' prognostication and risk stratification. Incorporating these tools in clinical practice has profoundly impacted on the decision-making process for the adjuvant therapy of patients with ER+/HER2- early breast cancer and the results from prospective adjuvant trials have strengthened the clinical utility of multigene signatures in this setting. In July 2019, Lombardy was the first Region in Italy to reimburse genomic testing for patients with ER+/HER2- early breast cancer. Three years later, a group of investigators from six referral Cancer Centers in Lombardy convened to debate the use of multigene signatures in clinical practice and share their own experience with the tests after reimbursement. Here, we reviewed relevant data on the role of multigene signatures in tailoring adjuvant chemotherapy for patients with ER+/HER2- early breast cancer and discussed about the optimal use of these assays in current clinical practice. As the treatment landscape of early breast cancer evolves and novel questions about the possible additional applications of multigene assays arise, we also provide our viewpoint on the potential implementation of the assays in the evolving scenario ER+/HER2- early breast cancer treatment.
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Affiliation(s)
- Luca Licata
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
- *Correspondence: Luca Licata,
| | - Deborah Cosentini
- Medical Oncology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Rita De Sanctis
- Medical Oncology and Hematology Unit, IRCCS - Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Monica Iorfida
- Division of Medical Senology, IEO, European Institute of Oncology, Milan, Italy
| | | | - Andrea Vingiani
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | | | - Giancarlo Pruneri
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Elisabetta Munzone
- Division of Medical Senology, IEO, European Institute of Oncology, Milan, Italy
| | - Giampaolo Bianchini
- Department of Medical Oncology, San Raffaele Hospital, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Zambelli
- Medical Oncology and Hematology Unit, IRCCS - Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlo Tondini
- Oncology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
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Cao B, Yang S, Yan L, Li N. Comprehensive serum lipidomic analyses reveal potential biomarkers for malignant breast cancer: A case-control study. Cancer Biomark 2023; 37:289-297. [PMID: 37302027 DOI: 10.3233/cbm-220462] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Breast cancer is the most worldwide commonly found malignancy among women. The evidence for lipidomic studies of breast cancer in the Chinese population is relatively limited. OBJECTIVE Our current study aimed to identify peripheral lipids capable of distinguishing adults with and without malignant breast cancer in a Chinese population and to explore the potential lipid metabolism pathways implicated in breast cancer. METHODS Lipidomics was performed with an Ultimate 3000 UHPLC system coupled with a Q-Exactive HF MS platform by using the serum of 71 female patients with malignant breast cancer and 92 age-matched (± 2 years) healthy women. The data were uploaded to and processed by the specialized online software Metaboanalyst 5.0. Both univariate and multivariate analyses were carried out for potential biomarker screening. Areas under the receiver-operating characteristic (ROC) curves (AUCs) of identified differential lipids were obtained for evaluating their classification capacity. RESULTS A total of 47 significantly different lipids were identified by applying the following criteria: false discovery rate-adjusted P < 0.05, variable importance in projection ⩾ 1.0, and fold change ⩾ 2.0 or ⩽ 0.5. Among them, 13 lipids were identified as diagnostic biomarkers with the area under curve (AUC) greater than 0.7. Multivariate ROC curves indicated that AUCs greater than 0.8 could be achieved with 2-47 lipids. CONCLUSIONS Using an untargeted LC-MS-based metabolic profiling approach, our study provides preliminary evidence that extensive dysregulations of OxPCs, PCs, SMs and TAGs were involved in the pathological processes of breast cancer. We provided clues for furtherly investigating the role of lipid alterations in the pathoetiology of breast cancer.
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Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality (SWU), Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Siyu Yang
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
- Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
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Di Pilla A, Cozzolino MR, Mannocci A, Carini E, Spina F, Castrini F, Grieco A, Messina R, Damiani G, Specchia ML. The Impact of Tumor Boards on Breast Cancer Care: Evidence from a Systematic Literature Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14990. [PMID: 36429708 PMCID: PMC9690234 DOI: 10.3390/ijerph192214990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is the most common malignancy in women, with a complex clinical path that involves several professionals and that requires a multidisciplinary approach. However, the effectiveness of breast cancer multidisciplinary care and the processes that contribute to its effectiveness have not yet been firmly determined. This study aims to evaluate the impact of multidisciplinary tumor boards on breast cancer care outcomes. A systematic literature review was carried out through Scopus, Web of Science and Pubmed databases. The search was restricted to articles assessing the impact of MTB implementation on breast cancer care. Fourteen studies were included in the review. The most analyzed outcomes were diagnosis, therapy and survival. Four out of four studies showed that, with implementation of an MTB, there was a change in diagnosis, and all reported changes in the treatment plan after MTB implementation. A pooled analysis of three studies reporting results on the outcome "mortality" showed a statistically significant 14% reduction in mortality relative risk for patients enrolled versus not enrolled in an MTB. This study shows that MTB implementation is a valuable approach to deliver appropriate and effective care to patients affected by breast cancer and to improve their outcomes.
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Affiliation(s)
- Andrea Di Pilla
- Clinical Governance Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | | | - Alice Mannocci
- Faculty of Economics, Università “Universitas Mercatorum”, Piazza Mattei 10, 00186 Rome, Italy
| | | | - Federica Spina
- Department of Maternal, Children and Adult Medical and Surgical Sciences, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, Italy
| | - Francesco Castrini
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Albino Grieco
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Rosaria Messina
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Gianfranco Damiani
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Women, Children and Public Health Sciences Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Maria Lucia Specchia
- Clinical Governance Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
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15
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The Effect of MDT Collaborative Nursing Combined with Hierarchical Nursing Management Model on the Quality of Life and Comfort of Patients with Gallbladder Stones Combined with Acute Cholecystitis after Surgery. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8696084. [PMID: 35734780 PMCID: PMC9208964 DOI: 10.1155/2022/8696084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/05/2022] [Accepted: 05/24/2022] [Indexed: 12/07/2022]
Abstract
Objective To explore the effect of MDT (multidisciplinary team) collaborative nursing combined with hierarchical nursing management mode on the quality of life and comfort of patients with gallbladder stones combined with acute cholecystitis after surgery. Methods A total of 120 patients with gallbladder stones and acute cholecystitis who were treated in our hospital from March 2019 to March 2021 were selected as prospective research objects. According to the order of care, they were divided into control group and observation group with 60 cases each. Among them, the control group implements a hierarchical nursing management model, and the observation group implements MDT collaborative nursing based on this and compares the impact of the two groups on patient's quality of life scores, daily self-care ability, nursing satisfaction, and comfort after nursing. Results Before nursing, the comparison of the quality of life score, nursing comfort, and nursing ability of the two groups of patients was not statistically significant (P > 0.05). After nursing, the mental vitality score, social interaction score, emotional restriction score, and mental status of the observation group were significantly higher than those of the control group. Statistics showed that the difference was statistically significant (P < 0.05). After nursing, the scores of social comfort, physical comfort, and psychological comfort of the observation group were significantly higher than those of the control group, and statistics showed that the difference was statistically significant (P < 0.05). The health knowledge level, self-care skills, self-care responsibility, and self-concept of the observation group after nursing were higher than those of the control group, while the score of depression and mood disorder was significantly lower than that of the control group. Statistics showed that this difference was statistically significant (P < 0.05). After nursing, patients in the observation group had higher operating technique scores, service attitude scores, health education scores, psychological intervention scores, and nursing quality scores than those of the control group. Statistics showed that the difference was statistically significant (P < 0.05). Conclusion MDT collaborative nursing combined with hierarchical nursing management mode can effectively improve the self-care ability of patients with gallbladder stones complicated with acute cholecystitis, effectively improve the quality of life of patients, and improve the satisfaction and comfort of patients with nursing care. The postnursing care of patients after inflammation has a certain reference value.
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Zhang B, Zhou J, Xie W, Tao K, Lu S, Yuan X, Liu L, Wang W, Mao Y, Bie P, Liu J, Bi X, Zhang Z, Liang C, Cai J, Jian Z, Lv Y, Zhu P, Zhang W, Yang H, Zhou W, Zhang B, Chen X. Expert consensus on organizing the multidisciplinary team (MDT) diagnosis and treatment of hepato-pancreato-biliary diseases in China. SCIENCE CHINA. LIFE SCIENCES 2022; 65:1036-1039. [PMID: 35314917 DOI: 10.1007/s11427-021-2079-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Binhao Zhang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jian Zhou
- Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Weifen Xie
- Shanghai Changzheng Hospital, Shanghai, 200003, China
| | - Kaishan Tao
- Xijing Hospital of Air Force Medical University, Xi'an, 710032, China
| | - Shichun Lu
- Chinese PLA General Hospital, Beijing, 100048, China
| | - Xianglin Yuan
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Lianxin Liu
- The First Affiliated Hospital of University of Science and Technology of China, Hefei, 230001, China
| | - Weilin Wang
- The Second Affiliated Hospital of Medical College of Zhejiang University, Hangzhou, 310009, China
| | - Yilei Mao
- Peking Union Medical College Hospital, Beijing, 100140, China
| | - Ping Bie
- The Third Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jingfeng Liu
- Fujian Medical University Cancer Hospital, Fuzhou, 350005, China
| | - Xinyu Bi
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, 100021, China
| | - Zhiwei Zhang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Changhong Liang
- Guangdong Provincial People's Hospital, Guangzhou, 510080, China
| | - Jianqiang Cai
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, 100021, China
| | - Zhixiang Jian
- Guangdong Provincial People's Hospital, Guangzhou, 510080, China
| | - Yi Lv
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Peng Zhu
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Zhang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hongqiang Yang
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610599, China
| | - Weiping Zhou
- The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, 201805, China
| | - Bixiang Zhang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Xiaoping Chen
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430030, China.
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Shen J, Wang M, Li F, Li Y, Zhou J, Sun W. Non-Inferiority Study on the Precise Implementation of Multidisciplinary Continuous Nursing Intervention in Patients with Breast Cancer Experiencing Negative Emotions. Cancer Manag Res 2022; 14:1759-1770. [PMID: 35634536 PMCID: PMC9130099 DOI: 10.2147/cmar.s354214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/17/2022] [Indexed: 12/09/2022] Open
Affiliation(s)
- Jun Shen
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Meng Wang
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Fan Li
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Yan Li
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Jun Zhou
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Wenwen Sun
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
- Correspondence: Wenwen Sun, Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, No. 6 Zhenhua East Road, High-Tech Square, LianYunGang, 222002, People’s Republic of China, Tel +86-18961325179, Email
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Xiang YY, Deng CC, Liu HY, Kuo ZC, Zhang CH, He YL. The Prognostic Effect of Multidisciplinary Team Intervention in Patients with Advanced Gastric Cancer. Curr Oncol 2022; 29:1201-1212. [PMID: 35200601 PMCID: PMC8871247 DOI: 10.3390/curroncol29020102] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 12/24/2022] Open
Abstract
Background: The effect of multidisciplinary team intervention (MDT) on the prognosis of advanced gastric cancer (GC) is still controversial. This study aims to analyze the effect of MDTs on the overall survival time of advanced gastric cancer patients. Methods: Patients with advanced GC who underwent surgical treatment between 2007 and 2014 were included in the study. They were divided into two groups; the MDT group received MDT treatment and the non-MDT group received conventional treatment. The Kaplan-Meier method was used to compare the overall survival (OS) of the two groups. The prognostic factors of advanced GC were evaluated by multivariate Cox regression analysis. Results: 394 patients were included in our study. Kaplan-Meier survival analysis showed that the prognosis of advanced GC patients with who underwent MDT intervention was better than those without (3-year OS of 55.6% vs. 46.1%, p = 0.005), Multivariate analysis indicated that MDT intervention could reduce mortality (HR = 0.493, p < 0.001). Conclusions: MDT intervention is an effective measure that improves the survival of patients with advanced GC.
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Affiliation(s)
- Yuan-Yuan Xiang
- Digestive Disease Center, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; (Y.-Y.X.); (C.-C.D.); (H.-Y.L.); (Z.-C.K.)
| | - Cun-Can Deng
- Digestive Disease Center, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; (Y.-Y.X.); (C.-C.D.); (H.-Y.L.); (Z.-C.K.)
| | - Han-Yuan Liu
- Digestive Disease Center, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; (Y.-Y.X.); (C.-C.D.); (H.-Y.L.); (Z.-C.K.)
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
| | - Zi-Chong Kuo
- Digestive Disease Center, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; (Y.-Y.X.); (C.-C.D.); (H.-Y.L.); (Z.-C.K.)
| | - Chang-Hua Zhang
- Digestive Disease Center, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; (Y.-Y.X.); (C.-C.D.); (H.-Y.L.); (Z.-C.K.)
- Correspondence: (C.-H.Z.); (Y.-L.H.)
| | - Yu-Long He
- Digestive Disease Center, Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China; (Y.-Y.X.); (C.-C.D.); (H.-Y.L.); (Z.-C.K.)
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China
- Correspondence: (C.-H.Z.); (Y.-L.H.)
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Temperley H, Waters C, Larkins K, Murray C, O'Sullivan NJ, Mockler D, Humm G, Norden C, Phoenix E, Donohoe CL, Warrier S, Mohan H. The educational value of the multi-disciplinary meeting (MDM) in surgical oncology: A systematic review and thematic content analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2022; 48:935-945. [DOI: 10.1016/j.ejso.2022.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/18/2022] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
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The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review. Cancers (Basel) 2021; 13:cancers13164159. [PMID: 34439312 PMCID: PMC8394238 DOI: 10.3390/cancers13164159] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/29/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Multidisciplinary team meetings have increasingly been implemented in cancer care worldwide to ensure timely, accurate and evidence-based diagnosis, and treatment plans. Nowadays, multidisciplinary team meetings are generally considered indispensable. However, they are considered time-consuming and expensive, while the effects of multidisciplinary team meetings are not yet fully understood. The aim of this systematic review is to update and summarize the literature and create an overview of the existing knowledge. Cancer types such as colorectal, lung, prostate and breast cancer with rapidly increasing incidence rates will inevitably impact the workload of clinicians. Understanding the effects of the widely implemented multidisciplinary team meetings in oncology care is fundamental in order to optimize care pathways and allocate resources in the rapidly diversifying landscape of cancer therapies. Abstract Objective: The aim of our systematic review is to identify the effects of multidisciplinary team meetings (MDTM) for lung, breast, colorectal and prostate cancer. Methods: Our systematic review, performed following PRISMA guidelines, included studies examining the impact of MDTMs on treatment decisions, patient and process outcomes. Electronic databases PUBMED, EMBASE, Cochrane Library and Web of Science were searched for articles published between 2000 and 2020. Risk of bias and level of evidence were assessed using the ROBINS-I tool and GRADE scale. Results: 41 of 13,246 articles were selected, evaluating colorectal (21), lung (10), prostate (6) and breast (4) cancer. Results showed that management plans were changed in 1.6–58% of cases after MDTMs. Studies reported a significant impact of MDTMs on surgery type, and a reduction of overall performed surgery after MDTM. Results also suggest that CT and MRI imaging significantly increased after MDTM implementation. Survival rate increased significantly with MDTM discussions according to twelve studies, yet three studies did not show significant differences. Conclusions: Despite heterogeneous data, MDTMs showed a significant impact on management plans, process outcomes and patient outcomes. To further explore the impact of MDTMs on the quality of healthcare, high-quality research is needed.
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Khiat S, Pibarot M, Roux J, Bottin P, Saïas J, Rives N, Courbiere B. Challenging cases in oncofertility: insights from a national specialized e-meeting for fertility preservation specialists. J Assist Reprod Genet 2021; 38:2445-2453. [PMID: 34291419 PMCID: PMC8294278 DOI: 10.1007/s10815-021-02275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/07/2021] [Indexed: 12/04/2022] Open
Abstract
Purpose To determine the use of a new specialized E-Meeting for Complex Cases in Oncofertility by fertility preservation specialists (FPSs) Material and methods We present 3 years of activity of the E-Meeting for Complex Cases in Oncofertility, a new tool created in September 2016 which allows national oncofertility experts to share viewpoints about challenging cases for which they do not have experience or sufficient data in order to provide them an emergency advice within 48 h. Second, a survey was conducted to evaluate the use of this e-meeting for participating FPSs. Results One hundred and four experts have joined the e-meeting since its set-up, and 109 challenging cases have been submitted. The mean age of the patients was 22.4 ± 8.9 years, and 87.0% were female. Each submitted case received on average of 1.8 ± 1.1 different strategies for FP and the opinions of 7.1 ± 3.4 experts. Among the FPSs who submitted cases, seeking opinions from other FPSs allowed them to confirm their care plan (N = 49, 84.4%), to offer different options to their patients (N = 34, 58.6%), and to compare their practices with those of other specialists (N = 23, 39.6%). All respondents reported a self-perceived improvement in their practice of oncologic FP (n = 80, 100.0%). Conclusion Specific attention should be paid to challenging cases for which the experiences of only a few individuals exist. Enhancing communication between FPSs through oncofertility networks, pooling experiences, and collecting the most complex cases is required to improve the management of these patients. Supplementary Information The online version contains supplementary material available at 10.1007/s10815-021-02275-1.
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Affiliation(s)
- Samuel Khiat
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France
| | - Michele Pibarot
- Regional Network of Cancerology ONCOPACA-Corse, hôpitaux Sud, 270, Boulevard Sainte-Marguerite, 13009, Marseille, France
| | - Jennifer Roux
- Regional Network of Cancerology ONCOPACA-Corse, hôpitaux Sud, 270, Boulevard Sainte-Marguerite, 13009, Marseille, France
| | - Pauline Bottin
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France
| | - Jacqueline Saïas
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France
| | - Nathalie Rives
- Biology of Reproduction-CECOS Laboratory, UNIROUEN, EA 4308 "Gametogenesis and Gamete Quality", Rouen University Hospital, Normandie Univ, 76031, Rouen, France
| | - Blandine Courbiere
- Pôle Femmes-Parents-Enfants, Centre Clinico-biologique AMP-CECOS, Plateforme Cancer et Fertilité ONCOPACA-Corse, Assistance-Publique des Hôpitaux de Marseille (AP-HM), La Conception, 147 bd Baille, 13005, Marseille, France. .,CNRS, IRD, Avignon Université, IMBE, Aix Marseille Univ, 13397, Marseille, France.
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22
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Hammond JB, Han GR, Cronin PA, Kosiorek HE, Rebecca AM, Casey WJ, Kruger EA, Teven CM, Pockaj BA. Exploring the Effect of Post-mastectomy complications on 5-year survival. Am J Surg 2020; 220:1422-1427. [PMID: 32921402 DOI: 10.1016/j.amjsurg.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/24/2020] [Accepted: 09/03/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Ramifications of postoperative complications on long-term survival after mastectomy are uncertain. METHODS Overall complications (Clavien-Dindo Grades I-IIIB) and wound complications were analyzed using the Kaplan-Meier method for impact on 5-year overall (OS) and disease-free survival (DFS). RESULTS A total of 378 patients underwent mastectomy alone (157, 41%) or mastectomy with reconstruction (221, 59%) for Stage I-III disease with a median follow-up of 5 years. Postoperative complications occurred in 186 patients (49%), requiring non-surgical (I/II = 83, 22%) or surgical (IIIa/IIIb = 103, 27%) management. Wound complications occurred in 140 patients (37%). Reconstruction was associated with a higher rate of complication (P < 0.001). Postoperative complications after mastectomy (with or without reconstruction) did not significantly affect OS or DFS. Wound complications also showed no significant effect on OS or DFS following mastectomy alone, or mastectomy with reconstruction. CONCLUSIONS Postoperative complications after mastectomy, with or without reconstruction, bear no significant impact on 5-year survival.
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Affiliation(s)
| | - Ga-Ram Han
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Patricia A Cronin
- Division of Surgical Oncology & Endocrine Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Heide E Kosiorek
- Department of Health Sciences Research, Section of Biostatistics, Mayo Clinic, Scottsdale, AZ, USA
| | - Alanna M Rebecca
- Division of Plastic & Reconstructive Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - William J Casey
- Division of Plastic & Reconstructive Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Erwin A Kruger
- Division of Plastic & Reconstructive Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Chad M Teven
- Division of Plastic & Reconstructive Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Barbara A Pockaj
- Division of Surgical Oncology & Endocrine Surgery, Mayo Clinic, Phoenix, AZ, USA.
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