Improved Survival After Multidisciplinary Team Decision-Making for Patients with Advanced Gastrointestinal Cancer: A Multicenter, Prospective, Noninterventional, Controlled Study

BackgroundFormal multidisciplinary team (MDT) discussions in clinical practice require time and space with unclear survival benefits for advanced gastrointestinal patients. This study aimed to investigate the long-term survival of patients with advanced gastrointestinal cancer after multidisciplinary team (MDT) decision-making.Materials and MethodsFrom June 2017 to June 2019, continuous MDT discussions on advanced gastrointestinal cancer were conducted in ten medical centers in China. MDT decisions and actual treatment received by patients were prospectively recorded. The primary endpoint was the difference in overall survival (OS) between patients in MDT decision implementation and nonimplementation groups. The secondary endpoints included the implementation rate of MDT decisions and subgroup survival analysis. ResultsA total of 461 MDT decisions of 455 patients were included in this study. The implementation rate of MDT decisions was 85·7%. Sex and previous treatment had an impact on MDT decision-making. The OS was 24·0 months and 17·0 months, respectively, in MDT decision implementation and nonimplementation groups. The implementation of MDT decisions significantly reduced the risk of death in the univariate analysis. The subgroup analysis showed a significant difference in survival analysis of patients with colorectal cancer, but no significant difference was found in patients with gastric cancer. The rate of secondary MDT discussion was very low. ConclusionMDT discussion can prolong the OS of patients with advanced gastrointestinal cancer, especially colorectal cancer. Scheduling of the next MDT discussion in time is necessary when the disease condition changes.