Effect of multidisciplinary team treatment on outcomes of patients with gastrointestinal malignancy

Table 1 Complicated cases of different types of cancer discussed at multidisciplinary team meetings n (%)

Variables	Rectal cancer	Colon cancer	Gastric cancer
Pre-operation	68 (33.10)	40 (30.77)	69 (38.12)
Postoperative progression1	121 (59.02)	62 (47.69)	101 (55.80)
Other condition	16 (7.80)	28 (21.54)	11 (6.08)
Total	205 (100)	130 (100)	181 (100)

¹Including patients with both local recurrence and distant metastasis.

Table 2 Baseline characteristics of 263 patients with locally advanced rectal cancer n (%)

Baseline characteristics	NT group		Control group	P value
	(n = 101)		(n = 162)
Sex
Male	57		88	0.737
Female	44		74
Age (yr)1	55 (51-59)		55 (50-60)	0.664
Distance of tumor from anal verge
< 5 cm	35 (34.7)		37 (22.8)	0.051
5-12 cm	66 (65.3)		125 (77.2)
Surgery
APR	25		32	0.422
LAR	76		130
Preoperative serum CEA level
Normal	52 (51.5)		82 (50.6)	0.745
Abnormal	35 (34.7)		52 (32.1)
Unknown	14 (13.9)		28 (17.3)
Pretreatment staging tools
MRI	61 (60.4)		66 (40.7)	< 0.001
ERUS	28 (27.7)		34 (21.0)
CT	12 (11.9)		62 (38.3)
Pretreatment TNM stage
IIA(T3 N0)	24 (23.8)		54 (34.0)	0.278
IIB (T4 N0)	4 (4.0)		4 (2.5)
IIIA (T1-2 N1)	3 (3.0)		8 (4.9)
IIIB (T3-4 N1)	32 (31.7)		37 (22.8)
IIIC (AnyT N2)	38 (37.6)		58 (35.8)
Pathologic TNM stage
I (T1-2 N0)	35 (34.7)		12 (7.4)	< 0.01
IIA (T3 N0)	26 (25.7)		54 (33.3)
IIB (T4 N0)	1 (1.0)		0 (0)
IIIA (T1-2 N1)	6 (5.9)		7 (4.3)
IIIB (T3-4 N1)	17 (16.8)		40 (24.7)
IIIC (AnyT N2)	16 (15.8)		49 (30.2)
Histologic differentiation
High		2 (2.0)	20 (12.3)	0.013
Moderate		70 (69.3)	110 (67.9)
Poor		24 (23.8)	24 (14.8)
Mucinous and signet		5 (5.0)	8 (4.9)
Lymphovascular invasion
Present		21 (20.8)	50 (30.9)	0.074
Absent		80 (79.2)	112 (69.1)

¹Values are medians (interquartile ranges). NT: Neoadjuvant therapy; APR: Abdominal-perineal resection; LAR: Low anterior resection; MRI: Magnetic resonance imaging; ERUS: Endorectal ultrasonography; CT: computed tomography; CEA: Carcinoembryonic antigen.

Table 3 Clinical outcome of patients in two groups n (%)

Clinical outcome	NT group	Control group	Odds ratio	P value
	(n = 101)	(n = 162)	(95% CI)
Sphincter preservation1	13 (37.14)	5 (13.51)	3.78 (1.18-12.13)	0.041
Local recurrence	4 (3.96)	18 (11.11)	0.33 (0.11-1.00)	0.042
Distant metastasis	22 (21.78)	36 (22.22)	0.87 (0.48-1.57)	0.933
5-yr disease-free survival rate	77 (76.24)	109 (67.28)	-	0.039
5-yr overall survival rate	78 (77.23)	113 (69.75)	-	0.049

¹Within the patients whose distance of tumor from anal verge were less than 5 cm, n = 72 (Table 1). NT: Neoadjuvant therapy.

Table 4 Multivariate analysis of overall survival rate by COX model (enter method)

Variables	Hazard ratio	95% CI	P value
Pretreatment CEA level	1.429	1.044-1.956	0.026
Pathologic TNM stage	1.440	1.137-1.825	0.002
Lymphovascular invasion	0.468	0.286-0.765	0.002
Sex	1.164	0.726-1.867	0.529
Age	0.700	0.424-1.156	0.163
Distance of tumor from anal verge	0.994	0.854-1.157	0.934
Pretreatment TNM stage	0.949	0.727-1.239	0.703
Surgery form (LAR or APR)	0.853	0.575-1.264	0.427
Histologic differentiation	0.969	0.822-1.142	0.706
NT	0.878	0.519-1.483	0.626

CEA: Carcinoembryonic antigen; LAR: Low anterior resection; APR:Abdominal-perineal resection; NT: Neoadjuvant therapy.