Multidisciplinary team quality improves the survival outcomes of locally advanced rectal cancer patients: A post hoc analysis of the STELLAR trial

作者：Huiying Ma, Haoyue Li, Tongzhen Xu, Yuanhong Gao, Shixin Liu, Wen‐Ling Wang, Lichun Wei, Xishan Wang, Liming Jiang, Yihebali Chi, Jinming Shi, Jiacheng Shuai, Shuangmei Zou, Yong Cai, Yuan Zhu, Guanghui Cheng, Hongyan Zhang, Xin Wang, Suyu Zhu, Jun Wang, Gaofeng Li, Jialin Yang, Kuan Zhang, Ningning Lu, Hui Fang, Shulian Wang, Ye‐Xiong Li, Haitao Zhou, Yuan Tang, Jing Jin · 发表于：Radiotherapy and Oncology · 年份：2024 · DOI：10.1016/j.radonc.2024.110524 · 被引用次数：7 · 研究领域：Global Cancer Incidence and Screening、Interprofessional Education and Collaboration、Interdisciplinary Research and Collaboration

PURPOSE: We sought to determine the association between multidisciplinary team (MDT) quality and survival of patients with locally advanced rectal cancer. METHODS: In a post hoc analysis of the randomized phase III STELLAR trial, 464 patients with distal or middle-third, clinical tumor category cT3-4 and/or regional lymph node-positive rectal cancer who completed surgery were evaluated. Disease-free survival (DFS) and Overall survival (OS) were stratified by Multidisciplinary team (MDT) quality, which was also included in the univariable and multivariable analyses of DFS and OS. RESULTS: According to the univariable analyses, a significantly worse DFS was associated with a fewer specialized medical disciplines participating in MDT (<5 vs ≥ 5; P=0.049),a lower frequency of MDT meetings (<once a week vs ≥ once a week; P=0.021) and a smaller MDT annual discussion volume of rectal cancer (≤200 vs > 200; P=0.039). In addition, a lower number of specialized medical disciplines participating in MDT (<5 vs ≥ 5; P<0.001), a lower frequency of MDT meetings (<once a week vs ≥ once a week; P<0.001) and a smaller MDT annual discussion volume of rectal cancer (≤200 vs > 200; P=0.001) were the variables associated with OS. These 3 factors were considered when assessing MDT quality, which was classified into 2 categories: high quality or general quality. Patients treated in hospitals with high MDT quality had longer 3-year OS (90.5 % vs 78.1 %; P=0.001) and similar 3-year DFS (70.3 % vs 61.3...