1. Impact of Multidisciplinary Team Management on Survival and Recurrence in Stage I–III Colorectal Cancer: A Population-Based Study in Northern Italy.
- Author
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Mangone, Lucia, Zizzo, Maurizio, Nardecchia, Melissa, Marinelli, Francesco, Bisceglia, Isabella, Braghiroli, Maria Barbara, Banzi, Maria Chiara, Damato, Angela, Cerullo, Loredana, Pellegri, Carlotta, Morabito, Fortunato, Neri, Antonino, Fabozzi, Massimiliano, Pinto, Carmine, and Giorgi Rossi, Paolo
- Subjects
COLORECTAL cancer ,PATIENT compliance ,RECTAL cancer ,OVERALL survival ,MEDICAL screening ,SURVIVAL analysis (Biometry) - Abstract
Simple Summary: Colorectal cancer is a frequent neoplasm in the general population in both males and females. If oncological screening allows for the early diagnosis of the neoplasm, when present, the management of tumors that are not detected at an early stage becomes more complex. In recent years, in the most cutting-edge hospitals, the establishment of dedicated therapeutic paths that include a team of professionals from different specialties (oncologist, surgeon, radiotherapist, pathologist, radiologist, and, frequently, psychologist and data manager) has become increasingly common. This work shows how, in a province of Northern Italy, the presence of a multidisciplinary team dedicated to the management of patients with colorectal cancer is able to best deal with the patient's recurrences and take care of the person throughout the disease's complexity. In the era of personalized medicine, personalization involves not only drugs but also the management of the person and not just the tumor. This study aimed to assess whether multidisciplinary team (MDT) management improves outcomes in patients with stage I–III colorectal cancer (CRC) compared to non-MDT care. This study included 460 CRC patients diagnosed from 2017 to 2018 in a northern Italian province, of whom 300 (65%) were managed by MDT. MDT patients were younger, more frequently had rectal cancers, were diagnosed at earlier stages, and were more likely to undergo surgery and chemotherapy. Disease-free survival (DFS) and overall survival (OS) were significantly better in the MDT group. The recurrence rate was 8.5%, with no significant differences between MDT and non-MDT patients, although MDT patients exhibited lower recurrence rates for early-stage tumors. A multivariable analysis showed that DFS and OS were adversely affected by older age, advanced stage, and lack of MDT management. Kaplan–Meier estimates demonstrated a 3-year DFS of 78% in the MDT group versus 65% in the non-MDT group, as well as an OS of 83% versus 69%, respectively. The MDT approach was associated with improved treatment adherence and better management of recurrences. While limited by a small sample size, this population-based study highlights the beneficial impact of MDT care on CRC outcomes. Further research with extended follow-up is warranted to confirm these findings. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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