Evaluation of diagnosis and treatment efficiency of multidisciplinary treatment in central nervous system tumors

doi:10.3877/cma.j.issn.2095-9141.2022.04.007

Abstract

Abstract:

Objective

To explore the efficiency of multidisciplinary treatment (MDT) in the diagnosis and treatment of patients with central nervous system (CNS).

Methods

The clinical data of 49 patients who attended the Neurosurgery MDT Clinic of the Second People’s Hospital of Shenzhen from June 2019 to June 2020 were retrospectively analyzed. Before MDT diagnosis and treatment, the feasible diagnosis and treatment of these patients had been discussed by the specialists, which would be compared with the diagnosis and treatment plan after MDT, to analyze the changes in diagnosis and treatment. These changes in diagnosis and treatment were further divided into two categories: major changes and minor changes according to literatures reporting criteria. The types and proportions of changes in diagnosis and treatment indexes before and after MDT were compared and analyzed statistically.

Results

Pre- and post-MDT diagnosis were consistent in 33 cases (67.3%), and were modified in 16 cases (32.7%). Of the diagnosis modified cases, 7 cases (14.3%) were major changes, and 9 cases were minor changes (18.3%). Pre- and post-treatment were consistent in 26 cases (53.1%), while 23 cases (46.9%) were changed, among which 15 cases (30.6%) were major changes, and 8 cases were minor changes (16.3%). There was no significant difference in the change rate and degree of diagnosis and treatment between different types of nerve tumors before and after MDT (P>0.05). The proportion of treatment changes in patients with recurrent tumors before and after MDT was higher than that in patients with primary tumors, and the proportion of major changes was higher than that of minor changes (P<0.05). At the same time, the proportion of treatment changes in patients with recurrent glioma before and after MDT was higher than that in patients with primary glioma (P<0.05).

Conclusion

There was no difference in MDT efficiency among different tumor types, but there was a significant difference in the efficiency of MDT of the diagnosis and treatment for recurrent CNS tumors, suggesting that due to the complexity of diagnosis and treatment, recurrent neuroneoplastic diseases need more intervention of MDT.

Key words: Multidisciplinary treatment, Multidisciplinary conference, Central nervous system tumor, Glioma, Efficiency

Chenglong Yu, Jing Liu, Fan Lin, Xiejun Zhang, Jihu Yang, Yufei Liu, Lei Chen, Mali Zhang, Taipeng Jiang, Weiping Li, Guodong Huang, Fanfan Chen. Evaluation of diagnosis and treatment efficiency of multidisciplinary treatment in central nervous system tumors[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(04): 229-235.

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References 23

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项目		MDT后诊断是否改变		χ ²值	P值	MDT后治疗是否改变		χ ²值	P值
项目		是（n=16）	否（n=33）	χ ²值	P值	是（n=23）	否（n=26）	χ ²值	P值
性别				1.408	0.235			2.115	0.146
	男性	12（38.7）	19（61.3）			17（54.8）	14（45.2）
	女性	4（22.2）	14（77.8）			6（33.3）	12（66.7）
年龄				3.781	0.151			5.452	0.065
	<30岁	3（27.2）	8（72.8）			6（54.5）	5（45.5）
	30~65岁	13（38.2）	21（61.8）			17（50.0）	17（50.0）
	>65岁	0（0）	4（100）			0（0）	4（100）
神经肿瘤类型				2.737	0.254			0.462	0.794
	胶质瘤	11（36.7）	19（63.3）			13（43.3）	17（56.7）
	垂体瘤	1（11.1）	8（88.9）			5（55.6）	4（44.4）
	其他神经肿瘤	4（40.0）	6（60.0）			5（50.0）	5（50.0）
初发/复发				1.238	0.266			7.234	0.007
	初发	7（25.9）	20（74.1）			8（29.6）	19（70.4）
	复发	9（40.9）	13（59.1）			15（68.2）	7（31.8）

项目		MDT后诊断是否改变		χ ²值	P值	MDT后治疗是否改变		χ ²值	P值
项目		是（n=16）	否（n=33）	χ ²值	P值	是（n=23）	否（n=26）	χ ²值	P值
性别				1.408	0.235			2.115	0.146
	男性	12（38.7）	19（61.3）			17（54.8）	14（45.2）
	女性	4（22.2）	14（77.8）			6（33.3）	12（66.7）
年龄				3.781	0.151			5.452	0.065
	<30岁	3（27.2）	8（72.8）			6（54.5）	5（45.5）
	30~65岁	13（38.2）	21（61.8）			17（50.0）	17（50.0）
	>65岁	0（0）	4（100）			0（0）	4（100）
神经肿瘤类型				2.737	0.254			0.462	0.794
	胶质瘤	11（36.7）	19（63.3）			13（43.3）	17（56.7）
	垂体瘤	1（11.1）	8（88.9）			5（55.6）	4（44.4）
	其他神经肿瘤	4（40.0）	6（60.0）			5（50.0）	5（50.0）
初发/复发				1.238	0.266			7.234	0.007
	初发	7（25.9）	20（74.1）			8（29.6）	19（70.4）
	复发	9（40.9）	13（59.1）			15（68.2）	7（31.8）

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