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Dynamic multidisciplinary team discussions can improve the prognosis of metastatic castration‐resistant prostate cancer patients
Author(s) -
Zhu Sha,
Chen Junru,
Ni Yuchao,
Zhang Haoran,
Liu Zhenhua,
Shen Pengfei,
Sun Guangxi,
Liang Jiayu,
Zhang Xingming,
Wang Zhipeng,
Wei Qiang,
Li Xiang,
Chen Ni,
Li Zhiping,
Wang Xin,
Shen Yali,
Yao Jin,
Huang Rui,
Liu Jiyan,
Cai Diming,
Zeng Hao
Publication year - 2021
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.24167
Subject(s) - prostate cancer , medicine , castration , multidisciplinary approach , multidisciplinary team , oncology , prostate , prostate disease , cancer , gynecology , hormone , nursing , social science , sociology
Abstract Background Multidisciplinary team (MDT) management is a popular treatment paradigm in managing cancer patients, which provides fully‐discussed, interdisciplinary treatment recommendations for patients. However, there has been a lack of data on its actual impact on the overall survival (OS) of metastatic castration‐resistant prostate cancer (mCRPC) patients. mCRPC is the end stage of prostate cancer, facing a treatment dilemma of overwhelming options; therefore, we hypothesize dynamic MDT discussions can be helpful in comprehensively managing these patients. Methods We retrospectively collected 422 mCRPC patients' clinical information from 2013 to 2020 from our institute. Patients can voluntarily choose whether to enroll in the dynamic MDT group, which includes discussions at CRPC diagnosis and subsequent disease progression. All patients were followed up regularly, and OS from CRPC diagnosis to death was set as the endpoint of this study. Results Participating in MDT discussions is a favorable independent indicator of longer overall survival (median OS: MDT (+): 39.7 months; MDT (−): 27.0 months, hazard ratio: 0.549, p = .001). Moreover, this survival benefit of MDT remained in subgroups with first‐line therapy [median OS: MDT (+): not reached; MDT (−): 27.0 months, p = .001) and with multi‐line therapy until the end of follow‐up (median OS: MDT (+): 36.7 months; MDT (−): 25.6 months, p = .044). Conclusion Therefore, regular MDT discussions are valuable in the management of mCRPC patients. Clinicians are encouraged to tailor MDT discussions dynamically to provide mCRPC patients with a better and more individualized treatment plan and more prolonged survival. Take‐home messages● The MDT model is defined as dynamic MDT discussions at the time of mCRPC diagnosis and each time they progressed later on throughout the disease management. ● Prostate cancer MDT usually includes specialists in urologic oncology, pathology, chemotherapy, radiotherapy, ultrasound, imaging and nuclear medicine. ● MDT model can benefit mCRPC patients in terms of overall survival.