TY - JOUR
T1 - The impact of the multidisciplinary tumor board (MDTB) on the management of pancreatic diseases in a tertiary referral center
AU - Quero, Giuseppe
AU - Salvatore, Lisa
AU - Fiorillo, Claudio
AU - Bagala, C.
AU - Menghi, Roberta
AU - Maria, B.
AU - Cina, C.
AU - Laterza, Vito
AU - Di Stefano, B.
AU - Maratta, Maria Grazia
AU - Ribelli, Marta
AU - Galiandro, F.
AU - Mattiucci, Gian Carlo
AU - Brizi, Maria Gabriella
AU - Genco, E.
AU - D'Aversa, F.
AU - Zileri, L.
AU - Attili, Fabia
AU - Larghi, Alberto Leonardo
AU - Perri, Vincenzo
AU - Inzani, Frediano
AU - Gasbarrini, Antonio
AU - Valentini, Vincenzo
AU - Costamagna, Guido
AU - Manfredi, Riccardo
AU - Tortora, Giampaolo
AU - Alfieri, Sergio
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - multidisciplinary tumor board
KW - pancreatic cancer
KW - pancreatic disease management
KW - resectability assessment
KW - tumor response
KW - multidisciplinary tumor board
KW - pancreatic cancer
KW - pancreatic disease management
KW - resectability assessment
KW - tumor response
UR - http://hdl.handle.net/10807/177530
U2 - 10.1016/j.esmoop.2020.100010
DO - 10.1016/j.esmoop.2020.100010
M3 - Article
SN - 2059-7029
VL - 6
SP - 1
EP - 7
JO - ESMO Open
JF - ESMO Open
ER -