PDF(Pubmed)
Abstract：
Colorectal cancer emerged as the third most prevalent malignancy worldwide, affecting nearly 2 million individuals in the year 2020. This study elucidates the pivotal role of a multidisciplinary team (MDT) in influencing the prognosis, as measured by relative survival rates, depending upon the stage and age. Cases recorded in an Italian Cancer Registry between 2017 and 2018 were included. Relative survival was reported at 1 and 3 years after diagnosis comparing MDT vs. no-MDT approaches. During the study period, 605 CRCs were recorded while 361 (59.7%) were taken care of by an MDT. Compared to no-MDT, MDT patients were younger with earlier stages and received more surgery. One year after diagnosis, survival was 78.7% (90% in MDT vs. 62% in no-MDT); stratifying by stage, in the MDT group there was no survival advantage for stage I (97.2% vs. 89.9%) and II (96.8% vs. 89.4%), but an advantage was observed for stage III (86.4% vs. 56.9%) and stage IV (63.7% vs. 27.4%). Similar values were observed at 3 years where a marked advantage was observed for stages III (69.9% vs. 35.1%) and IV (29.2% vs. 5.1%). The univariable analysis confirmed an excess risk in the no-MDT group (HR 2.6; 95% CI 2.0-3.3), also confirmed in the multivariable regression analysis (HR 2.0; 95% CI 1.5-2.5). Despite the increase in the number of MDT patients in 2018 (from 50% to 69%), this does not correspond to an improvement in outcome.
摘要：
结直肠癌成为全球第三大最常见的恶性肿瘤，在2020年影响了近200万人。这项研究阐明了多学科团队（MDT）在影响预后方面的关键作用。以相对生存率衡量，取决于阶段和年龄。纳入了2017年至2018年意大利癌症登记处记录的病例。在诊断后1年和3年报告相对生存率，比较MDT与无MDT方法。在学习期间,记录了605个CRC，而361个（59.7％）由MDT处理。与无MDT相比，MDT患者更年轻，阶段更早，接受更多手术。确诊一年后,生存率为78.7%(MDT中的90%与无MDT中为62%)；按阶段分层，在MDT组中，I期没有生存优势(97.2%vs.89.9%）和II（96.8%与89.4%），但在第三阶段观察到了优势(86.4%vs.56.9%）和第四阶段（63.7%与27.4%）。在3年观察到类似的值，在第三阶段观察到明显的优势（69.9％vs.35.1%）和IV（29.2%与5.1%）。单变量分析证实了非MDT组的超额风险（HR2.6;95％CI2.0-3.3），在多变量回归分析中也得到了证实(HR2.0;95%CI1.5-2.5)。尽管2018年MDT患者人数有所增加（从50％增加到69％），这并不意味着结果的改善。
