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.
结直肠癌已成为全球第三大常见恶性肿瘤，2020年影响近200万患者。本研究阐明了多学科团队（MDT）根据分期和年龄对相对生存率所反映的预后产生的关键影响。研究纳入2017年至2018年意大利癌症登记处记录的病例，比较MDT与非MDT模式在诊断后1年及3年的相对生存率。研究期间共记录605例结直肠癌病例，其中361例（59.7%）由MDT管理。与非MDT组相比，MDT组患者更年轻、分期更早且接受手术比例更高。诊断一年后总生存率为78.7%（MDT组90% vs 非MDT组62%）；按分期分层分析显示，MDT组在Ⅰ期（97.2% vs 89.9%）和Ⅱ期（96.8% vs 89.4%）无生存优势，但在Ⅲ期（86.4% vs 56.9%）和Ⅳ期（63.7% vs 27.4%）观察到显著优势。三年生存率呈现相似趋势，Ⅲ期（69.9% vs 35.1%）和Ⅳ期（29.2% vs 5.1%）优势尤为明显。单变量分析证实非MDT组死亡风险显著升高（HR 2.6；95% CI 2.0–3.3），多变量回归分析亦验证此结果（HR 2.0；95% CI 1.5–2.5）。尽管2018年MDT患者比例从50%上升至69%，但并未对应生存结局的改善。
肿瘤(癌症)患者之家