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Clinical application of the multidisciplinary team in the diagnosis and treatment of colorectal liver metastasis |
ZENG Hui-ming XIAO Ling-hui XIE Wei |
Department of Gastrointestinal and Thyroid Surgery,the First People′s Hospital of Huizhou City |
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Abstract Objective To analyze and study the clinical application effect of multidisciplinary management (MDT) in the treatment of colorectal liver metastasis (CLMs).Methods A total of 42 patients with CLMs who treated in the First People′s Hospital of Huizhou City,Guangdong Province from January 2014 to April 2017 were selected as the research objects and divided into the control group and the observation group by random number table method,with 21 cases in each group.The control group was not achieved MDT,while the observation group was carried out multidisciplinary teamwork for diagnosis and treatment.The preoperative chemotherapy rate,chemotherapy completion conversion rate,surgical conditions and mortality rates of the two groups were compared.Results The preoperative chemotherapy rate and chemotherapy completion conversion rate of the observation group (95.23%,80.95%) were higher than those of the control group (58.33%,53.33%),and the differences were statistically significant (P<0.05).The proportion of primary resection or ablation in the observation group (76.92%) was higher than that of the control group (27.58%),and the difference was statistically significant (P <0.05).The surgical resection rate of metastases in the observation group(75.00%) was higher than that in the control group (33.33%),and the difference was statistically significant (P<0.05).There were no statistically significant differences in R0 resection rate,lymph node dissection rate,metastasis dissection rate and pathological complete remission rate between the two groups (P>0.05).The 1-year follow-up mortality rate of the observation group and the control group were 4.76% (1/21) and 9.52% (2/21).There was no statistically significant difference in the 1-year follow-up mortality rate between the two groups (P>0.05).The 2-year follow-up mortality rate of the observation group and the control group were 38.09% (8/21) and 61.90% (13/21).The 2-year follow-up mortality rate of the observation group was lower than that of the control group,and the difference was statistically significant (P<0.05).Conclusion The MDT model of multiple methods for sequential treatment of CLMs obtains a definite effect,which is conducive to standarde patient′s preoperative examination and intraoperative chemotherapy,and has a remarkable effect on improving the resection and ablation rate and the resection rate of metastases.It is worthy of clinical promotion and application.
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