TY - JOUR
T1 - Evaluation of multidisciplinary team decisions in neuroendocrine neoplasms
T2 - Impact of expert centres
AU - Zandee, Wouter T.
AU - Merola, Elettra
AU - Poczkaj, Karolina
AU - de Mestier, Louis
AU - Klümpen, Heinz Josef
AU - Geboes, Karen
AU - de Herder, Wouter W.
AU - Munir, Alia
N1 - Publisher Copyright:
© 2022 John Wiley & Sons Ltd.
PY - 2022/11
Y1 - 2022/11
N2 - Objective: To evaluate the impact of multidisciplinary team (MDT) meetings on the management of patients with neuroendocrine neoplasms (NENs). Methods: All newly referred gastro-entero-pancreatic (GEP)-NEN patients discussed from 1 April to 1 October 2017 in the MDT of seven European expert centres were prospectively included. The impact on patients' management was defined as a change in diagnosis, grade, stage or treatment. Results: A total of 292 patients were included, mainly small intestinal (siNENs) (32%) and pancreatic NENs (28%), with distant metastases in 51%. Patients had received prior surgery in 43% of cases and prior medical treatment in 32%. A significant change occurred in 61% of NENs: 7% changes in diagnosis, 8% in grade and 16% in stage. The MDT recommended a new treatment for 51% of patients, mainly surgery (9%) or somatostatin analogues (20%). A significant change was most frequently observed in patients with Stage IV disease (hazard ratio [HR] 3.6, 95% confidence interval [CI]: 1.9–6.9 vs. Stage I) and G2 NENs (vs. G1, HR 2.1 95% CI: 1.2–3.8). Conclusion: NEN-dedicated MDT discussion in expert centres yields significant management changes in over 60% of patients and thus represents the gold standard for the management of these patients.
AB - Objective: To evaluate the impact of multidisciplinary team (MDT) meetings on the management of patients with neuroendocrine neoplasms (NENs). Methods: All newly referred gastro-entero-pancreatic (GEP)-NEN patients discussed from 1 April to 1 October 2017 in the MDT of seven European expert centres were prospectively included. The impact on patients' management was defined as a change in diagnosis, grade, stage or treatment. Results: A total of 292 patients were included, mainly small intestinal (siNENs) (32%) and pancreatic NENs (28%), with distant metastases in 51%. Patients had received prior surgery in 43% of cases and prior medical treatment in 32%. A significant change occurred in 61% of NENs: 7% changes in diagnosis, 8% in grade and 16% in stage. The MDT recommended a new treatment for 51% of patients, mainly surgery (9%) or somatostatin analogues (20%). A significant change was most frequently observed in patients with Stage IV disease (hazard ratio [HR] 3.6, 95% confidence interval [CI]: 1.9–6.9 vs. Stage I) and G2 NENs (vs. G1, HR 2.1 95% CI: 1.2–3.8). Conclusion: NEN-dedicated MDT discussion in expert centres yields significant management changes in over 60% of patients and thus represents the gold standard for the management of these patients.
UR - http://www.scopus.com/inward/record.url?scp=85132396013&partnerID=8YFLogxK
U2 - 10.1111/ecc.13639
DO - 10.1111/ecc.13639
M3 - Article
AN - SCOPUS:85132396013
VL - 31
JO - European Journal of Cancer Care
JF - European Journal of Cancer Care
SN - 0961-5423
IS - 6
M1 - e13639
ER -