Subscribe to RSS
DOI: 10.1055/a-0658-1350
Impact of a dedicated multidisciplinary meeting on the management of superficial cancers of the digestive tract
Publication History
submitted 14 March 2018
accepted after revision 11 June 2018
Publication Date:
12 December 2018 (online)
Abstract
Background The recent development of endoscopic resection for superficial gastrointestinal cancers could justify the need for a dedicated oncological multidisciplinary meeting (MDM). The aim of our study was to evaluate the impact of the dedicated MDM on the management of superficial cancers of the digestive tract.
Methods A dedicated MDM was developed at our tertiary referral center. A retrospective review of the MDM conclusions for all patients referred from March 2015 to March 2017 was performed. Outcomes measurements were the outcomes of endoscopic resection, and the concordance rate between the MDM recommendations, European Society of Gastrointestinal Endoscopy (ESGE) guidelines, and final patient management.
Results In total, 153 patients with a median age of 69 years were included. Half of the patients had major comorbidities. The mean lesion size was 25 mm, and R0 and curative resection rate were 73.9 % and 56.9 %, respectively. Forty-three patients had an indication for surgery after endoscopic resection. The concordance rate between ESGE guidelines and MDM recommendation was 92.2 %, and 12 patients did not receive the treatment recommended due to comorbidities.
Conclusion A MDM dedicated to superficial tumors helped tailor the ESGE guidelines to each patient in order to avoid unnecessary surgery.
-
References
- 1 Epidémiologie. Internet: http://lesdonnees.e-cancer.fr/Themes/epidemiologie
- 2 Ono H, Yao K, Fujishiro M. et al. Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer: Early gastric cancer ESD/EMR guidelines. Dig Endosc 2016; 28: 3-15
- 3 Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy 2005; 37: 570-578
- 4 Barret M, Lepilliez V, Coumaros D. et al. Société Française d’Endoscopie Digestive (SFED). The expansion of endoscopic submucosal dissection in France: A prospective nationwide survey. United Eur Gastroenterol J 2017; 5: 45-53
- 5 Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T. et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47: 829-854
- 6 Shimoda T. [Japanese classification of esophageal cancer, the 10th edition – Pathological part]. Nihon Rinsho Jpn J Clin Med 2011; 69 (Suppl. 06) 109-120
- 7 Koelzer VH, Zlobec I, Lugli A. Tumor budding in colorectal cancer – ready for diagnostic practice?. Hum Pathol 2016; 47: 4-19
- 8 Napoleon B, Gincul R, Ponchon T. et al. Sociéte Française d’Endoscopie Digestive (SFED, French Society of Digestive Endoscopy). Endoscopic papillectomy for early ampullary tumors: long-term results from a large multicenter prospective study. Endoscopy 2014; 46: 127-134
- 9 Palmer J, Wales K, Ellis K. et al. The multidisciplinary colposcopy meeting: recommendations for future service provision and an analysis of clinical decision making: The multidisciplinary colposcopy meeting. BJOG Int J Obstet Gynaecol 2010; 117: 1060-1066