Multidisciplinary Team Treatment Model To The Clinical Value Of Colorectal Cancer Patients With Liver Metastases

Objective:At present,patients with liver metastases of colorectal cancer,the simple surgery,chemotherapy,radiation therapy,molecular targeted therapy,interventional therapy has benefits etc.But a single therapy has been difficult to obtain a satisfactory therapeutic effect.The diagnosis and treatment of multidisciplinary team has made a great contribution to solve this problem,and there is no clear report about its clinical profit.This study retrospectively collected the First Affiliated Hospital of Dalian Medical University(department of Oncology)were newly diagnosed cases of CRCLM patients,and analyze their clinical data.The purpose of this study was to evaluate the clinical value of MDT diagnosis and treatment model in CRCLM patients.Methods:During the period from August 2013 to February 2016,collecting patients from the First Affiliated Hospital of Dalian Medical University,stay in the oncology,who should suitable for the following indicators:(1)age>18 years old;male or female.(2)ECOG score of<2.(3)Colorectal cancer confirmed by pathology.(4)With liver metastasis confirmed by imaging.(5)In oncology outpatient or inpatient unit first diagnosed patients diagnosed with CRCLM,and without any previous treatment of tumor-associated(6)No previous history of cancer.(7)No extrahepatic metastases when newly diagnosed.(8)There was no serious heart disease before.All patients were followed up February 2017.According to whether to participate in MDT consultation during admission period,divided into MDT group and non MDT group.SPSS 20.0 statistical software was used to analyze the collected data,chi square test was used to compare clinical data in two groups(including age,gender,primary swelling tumor location,surgical resection rate,mortality after surgery for some time),paired t test was used to compare the quality of life before and after treatment,and the difference of quality of life between the two groups was compared by repeated measures analysis of variance,Kaplan-Meier method was used to analyze the survival of the two groups,the difference of P<0.05 was proof of difference.Results:After screening,a total of 114 eligible patients with CRCLM were collected.The MDT group has 53 patients(n=53).The non MDT group has 61 patients(n=61).1.General informationThe baseline data of the two groups,including age,gender,pathological type,primary site(location,degree of invasion,lymph node metastasis),liver metastasis(location,number,size)were not different,p>0.05.2.Surgical resection rateA total of 45 patients were treated by surgery,the overall resection rate 39.47%.In the MDT group,29 patients underwent surgical treatment,the surgical resection rate was 54.72%;In the non-MDT group,16 patients underwent surgical treatment.The surgical resection rate was 26.23%.The surgical resection rate in MDT patients was significantly higher than that in non-MDT group,the difference was significant(P<0.05).3.Quality of lifeIn physical function,emotional function,general health,nausea/vomiting and pain,the situation of patients in group MDT has improved than before treatment,P<0.05;while in another group patients felt better than before treatment only in physical functioning,general health,nausea/vomiting and pain,P<0.05.The improvement of the two groups has significant differences in physical function,emotional function,general health,nausea/vomiting and pain,p<0.05.4.Survival periodFollow-up ended in February 2017.The MDT group was followed up 4-41 months.the end,27 died and no cases were lost.The median OS,1,2-year survival rates were 26.04 ± 1.44 months,93.66%,56.71%.respectively.Non-MDT follow-up 3-40 months,followed by the end of 32 people died,lost 1 person.The median OS,1,2-year survival rates were 21.12 ± 1.39 months,85.94%and39.34%,respectively.There was no significant difference in the 1-year survival rate between the two groups(X2 = 2.34,P = 0.21).The median OS and 2-year survival rates in the MDT group were significantly higher than those in the non-MDT group(OS X2 = 5.00,P = 0.025,2-year survival rate X2 = 11.25,P = 0.001).Conclusion:1.MDT treatment mode can improve the surgical resection rate of patients with CRCLM.2.MDT treatment model can improve the quality of life of patients with CRCLM.3.MDT treatment mode can prolong the survival time of CRCLM patients(median OS,2-year survival rate),the impact on long-term survival needs to be further studied.