Multidisciplinary team meetings improve survival in patients with esophageal cancer
Lindblad, Mats ; Jestin, Christine ; Johansson, Jan LU
; Edholm, David
and Linder, Gustav
(2024)
In Diseases of the Esophagus
37(11).
- Abstract
Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs' effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan-Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80-90 years; odds ratio [OR]... (More)
Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs' effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan-Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80-90 years; odds ratio [OR] 0.25, 0.16-0.42 (95% confidence interval)) and clinical stage IVb (OR 0.65, 0.43-0.98) decreased the probability of being presented at an MDT, whereas high education level (OR 1.31, 1.02-1.67), being married (OR 1.20, 1.01-1.43), squamous histology (OR 1.50, 1.22-1.84) and later year of diagnosis (OR 1.33, 1.29-1.37 per year) increased the probability of an MDT. In multivariable adjusted analysis, MDT discussion was associated with improved survival (hazard ratios 0.72, 0.66-0.78) and median survival increased from 4.5 to 10.7 months. MDTs were associated with improved survival for esophageal cancer patients. Elderly patients with advanced disease and poor socioeconomic status were less likely to be presented at an MDT, but had clear survival-benefits if they were discussed in a multidisciplinary setting.
(Less)
- author
- Lindblad, Mats
; Jestin, Christine
; Johansson, Jan
LU
; Edholm, David
and Linder, Gustav
- organization
- publishing date
- 2024-11-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cancer, esophageal, survival
- in
- Diseases of the Esophagus
- volume
- 37
- issue
- 11
- article number
- doae061
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85208094154
- pmid:39119871
- ISSN
- 1120-8694
- DOI
- 10.1093/dote/doae061
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2024 The Author(s).
- id
- 78d8e02c-80fa-4008-b35e-27eb376b769c
- date added to LUP
- 2024-12-18 11:14:30
- date last changed
- 2025-07-17 04:15:27
@article{78d8e02c-80fa-4008-b35e-27eb376b769c,
abstract = {{<p>Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs' effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan-Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80-90 years; odds ratio [OR] 0.25, 0.16-0.42 (95% confidence interval)) and clinical stage IVb (OR 0.65, 0.43-0.98) decreased the probability of being presented at an MDT, whereas high education level (OR 1.31, 1.02-1.67), being married (OR 1.20, 1.01-1.43), squamous histology (OR 1.50, 1.22-1.84) and later year of diagnosis (OR 1.33, 1.29-1.37 per year) increased the probability of an MDT. In multivariable adjusted analysis, MDT discussion was associated with improved survival (hazard ratios 0.72, 0.66-0.78) and median survival increased from 4.5 to 10.7 months. MDTs were associated with improved survival for esophageal cancer patients. Elderly patients with advanced disease and poor socioeconomic status were less likely to be presented at an MDT, but had clear survival-benefits if they were discussed in a multidisciplinary setting.</p>}},
author = {{Lindblad, Mats and Jestin, Christine and Johansson, Jan and Edholm, David and Linder, Gustav}},
issn = {{1120-8694}},
keywords = {{cancer; esophageal; survival}},
language = {{eng}},
month = {{11}},
number = {{11}},
publisher = {{Oxford University Press}},
series = {{Diseases of the Esophagus}},
title = {{Multidisciplinary team meetings improve survival in patients with esophageal cancer}},
url = {{http://dx.doi.org/10.1093/dote/doae061}},
doi = {{10.1093/dote/doae061}},
volume = {{37}},
year = {{2024}},
}