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. 2024 Oct 28;37(11):doae061.
doi: 10.1093/dote/doae061.

Multidisciplinary team meetings improve survival in patients with esophageal cancer

Mats Lindblad  1 , Christine Jestin  2 , Jan Johansson  3 , David Edholm  4 , Gustav Linder  2
Affiliations

Multidisciplinary team meetings improve survival in patients with esophageal cancer

Mats Lindblad et al. Dis Esophagus. .

Abstract

Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs' effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan-Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80-90 years; odds ratio [OR] 0.25, 0.16-0.42 (95% confidence interval)) and clinical stage IVb (OR 0.65, 0.43-0.98) decreased the probability of being presented at an MDT, whereas high education level (OR 1.31, 1.02-1.67), being married (OR 1.20, 1.01-1.43), squamous histology (OR 1.50, 1.22-1.84) and later year of diagnosis (OR 1.33, 1.29-1.37 per year) increased the probability of an MDT. In multivariable adjusted analysis, MDT discussion was associated with improved survival (hazard ratios 0.72, 0.66-0.78) and median survival increased from 4.5 to 10.7 months. MDTs were associated with improved survival for esophageal cancer patients. Elderly patients with advanced disease and poor socioeconomic status were less likely to be presented at an MDT, but had clear survival-benefits if they were discussed in a multidisciplinary setting.

Keywords: cancer; esophageal; survival.

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Figures

Fig. 1
Fig. 1
Historic proportions of patients diagnosed with esophageal cancer in Sweden that were presented at an MDT.
Fig. 2
Fig. 2
Kaplan Meier curves displaying survival in esophageal cancer patients, conditional on the presentation to an MDT. Survival is presented for (A) the entire cohort, (B) patients older than 80 years, (C) patients with stage IV cancer and (D) patients with a Charleston comorbidity score of 3 or above.
See this image and copyright information in PMC

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