Effects of multidisciplinary team on the outcomes of colorectal cancer patients with liver metastases.

Abstract

To evaluate the effect of a multidisciplinary team (MDT) treatment modality on outcomes of patients with colorectal cancer with liver metastases (CRLMs) in China. We retrospectively identified 236 (MDT: 46, non-MDT: 190) patients who underwent liver resection or simultaneous resection for primary colorectal cancer and liver metastases with a curative intent for CRLMs at the National Cancer Center between January 2014 and June 2018. A 1:2 propensity score matching (PSM) analysis was used to adjust for differences in baseline characteristics between the MDT group and the non-MDT group. After the 1:2 PSM analysis, 46 patients were assigned to the MDT group, and 83 patients were assigned to the non-MDT group. All statistical analyses were performed using SPSS Statistics, version 22 (Armonk, NY, USA). Statistical significance was set at a 2-sided P<0.05. Before PSM analysis, compared to non-MDT patients, MDT patients had worse biological characteristics and were more likely to have node-positive primary tumors (80.4% vs. 63.2%), multiple liver metastases (73.9% vs. 50.5%), and liver metastases with a bilobar distribution (73.9% vs. 50.5%). However, MDT patients had a tendency towards better overall survival (OS) (P=0.169, median OS: 49.7 months vs. 35.2 months). After PSM analysis, no differences in clinicopathologic parameters were identified between the MDT group and the non-MDT group. Compared to non-MDT patients, MDT patients had a tendency towards better OS (P=0.063, median OS: 49.7 vs. 34.1 months). Multivariate analysis showed that having an MDT (HR, 0.550, 95% CI: 0.309-0.977, P=0.041) was an independent predictor of better OS. The MDT treatment modality can significantly improve the outcomes of CRLMs patients with poor biological characteristics in China.