Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2023; 15(9): 1616-1625
Published online Sep 15, 2023. doi: 10.4251/wjgo.v15.i9.1616
Multidisciplinary discussion and management of synchronous colorectal liver metastases: A single center study in China
Hao Li, Guo-Li Gu, Song-Yan Li, Yang Yan, Shi-Dong Hu, Ze Fu, Xiao-Hui Du
Hao Li, Ze Fu, Graduate School, Medical School of Chinese People’s Liberation Army, Beijing 100039, China
Hao Li, Guo-Li Gu, Department of General Surgery, Air Force Medical Center, Air Force Medical University, Beijing 100142, China
Song-Yan Li, Yang Yan, Shi-Dong Hu, Xiao-Hui Du, Department of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100039, China
Author contributions: Li H and Du XH were the guarantor of integrity of entire study, and contributed to the study concepts; Li H, Gu GL, Li SY, and Du XH designed the study; Li H, Gu GL, Li SY, and Hu SD involved in the literature research; Li H and Fu Z contributed to the data acquisition; Li H contributed to the statistical analysis/interpretation and manuscript preparation; Li H, Gu GL, Li SY, Hu SD, and Du XH contributed to the manuscript definition of intellectual content; Li H, Gu GL, and Du XH edited the manuscript.
Supported by National Natural Science Foundation of China, No. 81871317; and Military Medical Innovation Project, No. 18CXZ025.
Institutional review board statement: This study received approval from the ethics commission of the General Hospital of People’s Liberation Army.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: We are committed to promoting open data access. All research data generated as part of this study will be made available to the scientific community and interested parties, subject to legal, ethical, and privacy considerations.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Hui Du, MD, PhD, Chief Doctor, Deputy Director, Professor, Surgeon, Department of General Surgery, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100039, China. duxiaohui301@sina.com
Received: June 30, 2023
Peer-review started: June 30, 2023
First decision: July 24, 2023
Revised: July 24, 2023
Accepted: August 4, 2023
Article in press: August 4, 2023
Published online: September 15, 2023
Processing time: 75 Days and 0 Hours
Abstract
BACKGROUND

The multidisciplinary team (MDT) has been carried out in many large hospitals now. However, given the costs of time and money and with little strong evidence of MDT effectiveness being reported, critiques of MDTs persist.

AIM

To evaluate the effects of MDTs on patients with synchronous colorectal liver metastases and share our opinion on management of synchronous colorectal liver metastases.

METHODS

In this study we collected clinical data of patients with synchronous colorectal liver metastases from February 2014 to February 2017 in the Chinese People’s Liberation Army General Hospital and subsequently divided them into an MDT+ group and an MDT- group. In total, 93 patients in MDT+ group and 169 patients in MDT- group were included totally.

RESULTS

Statistical increases in the rate of chest computed tomography examination (P = 0.001), abdomen magnetic resonance imaging examination (P = 0.000), and preoperative image staging (P = 0.0000) were observed in patients in MDT+ group. Additionally, the proportion of patients receiving chemotherapy (P = 0.019) and curative resection (P = 0.042) was also higher in MDT+ group. Multivariable analysis showed that the population of patients assessed by MDT meetings had higher 1-year [hazard ratio (HR) = 0.608, 95% confidence interval (CI): 0.398-0.931, P = 0.022] and 5-year (HR = 0.694, 95%CI: 0.515-0.937, P = 0.017) overall survival.

CONCLUSION

These results proved that MDT management did bring patients with synchronous colorectal liver metastases more opportunities for comprehensive examination and treatment, resulting in better outcomes.

Keywords: Synchronous colorectal liver metastases, Multidisciplinary team, Imaging examination, Treatment strategy, Oncological outcome

Core Tip: Synchronous colorectal liver metastases usually predict a poor prognosis. Nevertheless, given the costs of time and money and with little strong evidence of multidisciplinary team (MDT) effectiveness being reported, critiques of MDTs still persist. This study demonstrates that MDT management brings patients more opportunities for aggressive examination and treatment. Retrospective clinical data shows that the population of patients assessed by MDT meetings has higher 1-year and 5-year overall survival.