The impact of multidisciplinary cancer conferences on overall survival: a meta-analysis

被引:14
|
作者
Huang, Ryan S. [1 ]
Mihalache, Andrew [1 ]
Nafees, Abdulwadud [2 ]
Hasan, Asad [3 ]
Ye, Xiang Y. [4 ]
Liu, Zhihui [4 ]
Leighl, Natasha B. [5 ]
Raman, Srinivas [6 ,7 ]
机构
[1] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada
[2] Univ Waterloo, Waterloo, ON, Canada
[3] Univ British Columbia, Vancouver, BC, Canada
[4] Univ Toronto, Princess Margaret Canc Ctr, Dept Biostat, Toronto, ON, Canada
[5] Univ Toronto, Princess Margaret Canc Ctr, Dept Med Oncol, Toronto, ON, Canada
[6] Univ Toronto, Princess Margaret Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada
[7] Univ Hlth Network, Princess Margaret Canc Ctr, 610 Univ Ave, Toronto, ON M5G 2M9, Canada
来源
关键词
SQUAMOUS-CELL CARCINOMA; TEAM CARE APPROACH; NATIONWIDE COHORT; COLORECTAL-CANCER; BREAST-CANCER; MANAGEMENT; OUTCOMES; IMPLEMENTATION; IMPROVES; INTERVENTION;
D O I
10.1093/jnci/djad268
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Multidisciplinary cancer conferences consist of regular meetings between diverse specialists working together to share clinical decision making in cancer care. The aim of this study was to systematically review and meta-analyze the effect of multidisciplinary cancer conference intervention on the overall survival of patients with cancer.Methods A systematic literature search was conducted on Ovid MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials for studies published up to July 2023. Studies reporting on the impact of multidisciplinary cancer conferences on patient overall survival were included. A standard random-effects model with the inverse variance-weighted approach was used to estimate the pooled hazard ratio of mortality (multidisciplinary cancer conference vs non-multidisciplinary cancer conference) across studies, and the heterogeneity was assessed by I2. Publication bias was examined using funnel plots and the Egger test.Results A total of 134 287 patients with cancer from 59 studies were included in our analysis, with 48 467 managed by multidisciplinary cancer conferences and 85 820 in the control arm. Across all cancer types, patients managed by multidisciplinary cancer conferences had an increased overall survival compared with control patients (hazard ratio = 0.67, 95% confidence interval = 0.62 to 0.71, I2 = 84%). Median survival time was 30.2 months in the multidisciplinary cancer conference group and 19.0 months in the control group. In subgroup analysis, a positive effect of the multidisciplinary cancer conference intervention on overall survival was found in breast, colorectal, esophageal, hematologic, hepatocellular, lung, pancreatic, and head and neck cancer.Conclusions Overall, our meta-analysis found a significant positive effect of multidisciplinary cancer conferences compared with controls. Further studies are needed to establish nuanced guidelines when optimizing multidisciplinary cancer conference integration for treating diverse patient populations.
引用
收藏
页码:356 / 369
页数:14
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