The role of the multidisciplinary tumor board (MDTB) in the assessment of pancreatic cancer diagnosis and resectability: A tertiary referral center experience

Frontiers in Surgery

Surgery

Maria Bensi¹  Lisa Salvatore¹  Federica Galiandro²  Davide De Sio²  Chiara Lucinato²  Claudio Fiorillo²  Vito Laterza²  Antonio Pio Tortorelli²  Giuseppe Massimiani²  Giuseppe Quero³  Fausto Rosa³  Roberta Menghi³  Valerio Papa³ 

[1] Gemelli Pancreatic Advanced Research Center (CRMPG), Università Cattolica del Sacro Cuore di Roma, Rome, Italy;Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome;Pancreatic Surgery Unit, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo Agostino Gemelli, Rome, Italy;Pancreatic Surgery Unit, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo Agostino Gemelli, Rome, Italy;Gemelli Pancreatic Advanced Research Center (CRMPG), Università Cattolica del Sacro Cuore di Roma, Rome, Italy;

关键词: pancreatic cancer;    multidisciplinary;    resectability;    diagnosis;    treatment response;   

DOI  :  10.3389/fsurg.2023.1119557

 received in 2022-12-08, accepted in 2023-01-31,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe introduction of multidisciplinary tumor boards (MDTBs) for the diagnostic and therapeutic pathway of several oncological disease significantly ameliorated patients' outcomes. However, only few evidences are currently present on the potential impact of the MDTB on pancreatic cancer (PC) management. Aim of this study is to report how MDTB may influence PC diagnosis and treatment, with particular focus on PC resectability assessment and the correspondence between MDTB definition of resectability and intraoperative findings.MethodsAll patients with a proven or suspected diagnosis of PC discussed at the MDTB between 2018 and 2020 were included in the study. An evaluation of diagnosis, tumor response to oncological/radiation therapy and resectability before and after the MDTB was conducted. Moreover, a comparison between the MDTB resectability assessment and the intraoperative findings was performed.ResultsA total of 487 cases were included in the analysis: 228 (46.8%) for diagnosis evaluation, 75 (15.4%) for tumor response assessment after/during medical treatment, 184 (37.8%) for PC resectability assessment. As a whole, MDTB led to a change in treatment management in 89 cases (18.3%): 31/228 (13.6%) in the diagnosis group, 13/75 (17.3%) in the assessment of treatment response cohort and 45/184 (24.4%) in the PC resectability evaluation group. As a whole, 129 patients were given indication to surgery. Surgical resection was accomplished in 121 patients (93.7%), with a concordance rate of resectability between MDTB discussion and intraoperative findings of 91.5%. Concordance rate was 99% for resectable lesions and 64.3% for borderline PCs.ConclusionsMDTB discussion consistently influences PC management, with significant variations in terms of diagnosis, tumor response assessment and resectability. In this last regard, MDTB discussion plays a key role, as demonstrated by the high concordance rate between MDTB resectability definition and intraoperative findings.

【 授权许可】

Unknown   
© 2023 Quero, De Sio, Fiorillo, Menghi, Rosa, Massimiani, Laterza, Lucinato, Galiandro, Papa, Salvatore, Bensi, Tortorelli, Tondolo and Alfieri.