Impact of multidisciplinary team intervention on long-term survival in distant metastatic colorectal cancer: Single-centre propensity score analyses.

Abstract

Multidisciplinary team (MDT) intervention is generally recommended in patients with distant metastatic colorectal cancer (DMCRC). However, it is not clear whether MDT intervention has a favourable impact on prognosis. We investigated the impact of MDT intervention on improving long-term prognosis in DMCRC. Patients who started treatment for DMCRC at our hospital in 2013-2017 were classified into an MDT group and a non-MDT group according to whether there was MDT intervention. Multivariable analysis was performed to identify factors that contributed to overall survival (OS). Three propensity score analyses (regression adjustment, stratification and matching) were performed. A total of 404 patients were treated for DMCRC (MDT group, n = 237; non-MDT group, n = 167). Multivariable analysis by Cox proportional hazards analysis showed that MDT intervention was significantly associated with OS improvement (hazard ratio [HR] 0.687; 95% confidence interval [CI] 0.515-0.917; p = 0.011). In the propensity score-matched cohort, the percentage of patients who underwent curative-intent surgery was significantly higher and median OS tended to be longer in the MDT group than in the non-MDT group (32.8 months vs. 24.1 months; p = 0.088). Regression adjustment and stratification analysis revealed that MDT intervention was associated with OS improvement (regression adjustment, HR 0.723; 95% CI 0.548-0.954; p = 0.022) (stratification analysis, HR 0.701; 95% CI 0.528-0.931; p = 0.014). The high percentage of curative-intent surgeries performed with MDT intervention suggests that MDT intervention may improve the chances of long-term survival in patients with DMCRC.