Abstract
BackgroundThe implementation of multidisciplinary tumor board (MDTB) meetings significantly ameliorated the management of oncological diseases. However, few evidences are currently present on their impact on pancreatic cancer (PC) management. The aim of this study was to evaluate the impact of the MDTB on PC diagnosis, resectability and tumor response to oncological treatment compared with indications before discussion.Patients and methodsAll patients with a suspected or proven diagnosis of PC presented at the MDTB from 2017 to 2019 were included in the study. Changes of diagnosis, resectability and tumor response to oncological/radiation treatment between pre- and post-MDTB discussion were analyzed.ResultsA total of 438 cases were included in the study: 249 (56.8%) were presented as new diagnoses, 148 (33.8%) for resectability assessment and 41 (9.4%) for tumor response evaluation to oncological treatment. MDTB discussion led to a change in diagnosis in 54/249 cases (21.7%), with a consequent treatment strategy variation in 36 cases (14.5%). Change in resectability was documented in 44/148 cases (29.7%), with the highest discrepancy for borderline lesions. The treatment strategy was thus modified in 27 patients (18.2%). The MDTB brought a modification in the tumor response assessment in 6/41 cases (14.6%), with a consequent protocol modification in four (9.8%) cases.ConclusionsMDTB discussion significantly impacts on PC management, especially in high-volume centers, with consistent variations in terms of diagnosis, resectability and tumor response assessment compared with indications before discussion.
Highlights
Despite the recent introduction of multimodal treatment strategies, pancreatic cancer (PC) still remains the fourth cause of cancer-related death, and it is expected to become the second by 2030.1,2 Currently, surgical resectionVolume 6 - Issue 1 - 2021 represents the mainstay of cure
After Institution Review Board approval, all patients with a proven or suspected diagnosis of PC referred to the multidisciplinary tumor board (MDTB) of the Fondazione Policlinico Universitario Agostino Gemelli IRCCS of Rome from November 2017 to December 2019 were retrospectively included in the study
The study population included 378 patients for a total of 438 consecutive cases discussed at the PC-MDTB of the Fondazione Policlinico Universitario Agostino Gemelli IRCCS of Rome from November 2017 to December 2019
Summary
Despite the recent introduction of multimodal treatment strategies, pancreatic cancer (PC) still remains the fourth cause of cancer-related death, and it is expected to become the second by 2030.1,2 Currently, surgical resectionVolume 6 - Issue 1 - 2021 represents the mainstay of cure. The aim of this study was to evaluate the impact of the MDTB on PC diagnosis, resectability and tumor response to oncological treatment compared with indications before discussion. Resectability and tumor response to oncological/radiation treatment between pre- and post-MDTB discussion were analyzed. Results: A total of 438 cases were included in the study: 249 (56.8%) were presented as new diagnoses, 148 (33.8%) for resectability assessment and 41 (9.4%) for tumor response evaluation to oncological treatment. MDTB discussion led to a change in diagnosis in 54/249 cases (21.7%), with a consequent treatment strategy variation in 36 cases (14.5%). Conclusions: MDTB discussion significantly impacts on PC management, especially in high-volume centers, with consistent variations in terms of diagnosis, resectability and tumor response assessment compared with indications before discussion.
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