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The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China.

ABSTRACT: This study aimed to explore whether different multidisciplinary team (MDT) organizations have different effects on the survival of breast cancer patients. A total of 16354 patients undergoing breast cancer surgery during the period 2006-2016 at the Fudan University Shanghai Cancer Center were retrospectively extracted. Patients treated by MDT were divided into a well-organized group and a disorganized group based on their organized MDT, professional attendance, style of data and information delivery, and the length of discussion time for each patient. Other patients, who were not treated by MDT, were placed in a non-MDT group as a comparator group. Each MDT patient was matched with a non-MDT patient, using propensity score matching to reduce selection bias. The Cox regression model was used to examine the difference in effects between groups. We found that the five-year survival rate of the well-organized MDT group was 15.6% higher than the non-MDT group. However, five-year survival rate of the disorganized MDT group was 19.9% lower than that of the non-MDT group. Patients in the well-organized MDT group had a longer survival time than patients in the non-MDT group (HR = 0.4), while the disorganized MDT group had a worse survival rate than the non-MDT group (HR = 2.8) based on the Cox model result. However, our findings indicate that a well-organized MDT may improve the survival rate of patients with breast cancer in China.

SUBMITTER: Lu J

PROVIDER: S-EPMC6982185 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China.

Lu Jianlong J Jiang Yan Y Qian Mengcen M Lv Lilang L Ying Xiaohua X

International journal of environmental research and public health 20191231 1

This study aimed to explore whether different multidisciplinary team (MDT) organizations have different effects on the survival of breast cancer patients. A total of 16354 patients undergoing breast cancer surgery during the period 2006-2016 at the Fudan University Shanghai Cancer Center were retrospectively extracted. Patients treated by MDT were divided into a well-organized group and a disorganized group based on their organized MDT, professional attendance, style of data and information deli ...[more]

PMID: 31906051

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Project description:BackgroundAcute pulmonary embolism remains a significant cause of mortality and morbidity worldwide. Benefit of recently developed multidisciplinary PE response teams (PERT) with higher utilization of advanced therapies has not been established.MethodsTo evaluate patient-centered outcomes and cost-effectiveness of a multidisciplinary PERT we performed a retrospective analysis of 554 patients with acute PE at the university of Virginia between July 2014 and June 2015 (pre-PERT era) and between April 2017 through October 2018 (PERT era). Six-month survival, hospital length-of-stay (LOS), type of PE therapy, and in-hospital bleeding were assessed upon collected data.Results317 consecutive patients were treated for acute PE during an 18-month period following institution of a multidisciplinary PE program; for 120 patients PERT was activated (PA), the remaining 197 patients with acute PE were considered as a separate, contemporary group (NPA). The historical, comparator cohort (PP) was composed of 237 patients. These 3 groups were similar in terms of baseline demographics, comorbidities and risk, as assessed by the Pulmonary Embolism Severity Index (PESI). Patients in the historical cohort demonstrated worsened survival when compared with patients treated during the PERT era. During the PERT era no statistically significant difference in survival was observed in the PA group when compared to the NPA group despite significantly higher severity of illness among PA patients. Hospital LOS was not different in the PA group when compared to either the NPA or PP group. Hospital costs did not differ among the 3 cohorts. 30-day re-admission rates were significantly lower during the PERT era. Rates of advanced therapies were significantly higher during the PERT era (9.1% vs. 2%) and were concentrated in the PA group (21.7% vs. 1.5%) without any significant rise in in-hospital bleeding complications.ConclusionsAt our institution, all-cause mortality in patients with acute PE has significantly and durably decreased with the adoption of a PERT program without incurring additional hospital costs or protracting hospital LOS. Our data suggest that the adoption of a multidisciplinary approach at some institutions may provide benefit to select patients with acute PE.

Dataset Information

The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China.

Publications

The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China.

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