The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Study Design
2.3. Variables
2.4. Data Analysis
3. Results
3.1. Basic Characteristics of the Pre-PSM and Post-PSM Samples
3.2. Overall Survival Differences between MDT Group and N-MDT Group During 2006--2016
3.3. Differential Effects of MDT before and after the Year of 2011
4. Discussion
4.1. The Explanation of the Results
4.2. Strengths and Limitations of This Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Determinants | Before 2011 | After 2011 |
---|---|---|
(Disorganized MDT) | (Well-Organized MDT) | |
Organization | Chairman | Secretary |
Attendance | Surgeons, physicians, Imaging doctors | Surgeons, physicians, Imaging doctors, Pathology doctor |
Information delivery | At the meeting | Before the meeting |
Number of patients | Unlimited | About four patients |
Discussion time per patient | 5–10 min | 20–30 min |
Patient data | Photographic, paper | Electronic |
Variables | MDT | N-MDT | MDT vs. N-MDT p Value γ | ||||||
---|---|---|---|---|---|---|---|---|---|
Before 2011 (n = 135) | After 2011 (n = 164) | Total (n = 299) | p Value α | Before 2011 (n = 5332) | After 2011 (n = 10,723) | Total (n = 16,055) | p Value β | ||
Age,yr | |||||||||
mean (SD) | 48.8 (11.9) | 51.5 (13.8) | 50.2 (12.9) | 0.059 | 52.3 (11.2) | 51.7 (11.2) | 51.9 (11.2) | 0.013 | 0.031 |
Charlson comorbidity index | |||||||||
mean (SD) | 0.2 (0.5) | 0.4 (0.6) | 0.3 (0.5) | 0.000 | 0.2 (0.5) | 0.2 (0.5) | 0.2 (0.5) | 0.337 | 0.016 |
TNM | |||||||||
0 | 0.0% | 0.0% | 0.0% | 0.442 | 1.4% | 2.2% | 1.9% | < 0.001 | < 0.001 |
1 | 4.4% | 5.5% | 5.0% | 35.8% | 37.9% | 37.2% | |||
2 | 32.6% | 32.3% | 32.4% | 47.4% | 47.6% | 47.5% | |||
3 | 56.3% | 46.3% | 50.8% | 14.8% | 11.7% | 12.7% | |||
4 | 6.7% | 15.9% | 11.7% | 0.6% | 0.7% | 0.7% | |||
Bilateral incidence | |||||||||
unilateral | 91.9% | 88.4% | 90.0% | 0.325 | 98.2% | 98.5% | 98.4% | 0.153 | < 0.001 |
bilateral | 8.2% | 11.6% | 10.0% | 1.8% | 1.5% | 1.6% | |||
ER | |||||||||
positive | 45.2% | 43.9% | 44.5% | 0.894 | 60.7% | 57.0% | 58.2% | 0.060 | < 0.001 |
negative | 37.0% | 34.8% | 35.8% | 21.3% | 21.6% | 21.5% | |||
HER2 | |||||||||
positive | 18.5% | 26.2% | 22.7% | 0.091 | 14.8% | 21.7% | 19.4% | < 0.001 | 0.034 |
negative | 55.6% | 47.6% | 51.2% | 66.0% | 56.3% | 59.5% |
Variables | MDT | N-MDT | |||||||
---|---|---|---|---|---|---|---|---|---|
Before 2011 (n = 98) | After 2011 (n = 120) | Total (n = 218) | p Value α | Before 2011 (n = 101) | After 2011 (n = 117) | Total (n = 218) | p Value β | MDT vs. N-MDT p Value γ | |
Age,yr | |||||||||
mean (SD) | 48.9 (11.5) | 51.4 (13.2) | 50.3 (12.5) | 0.196 | 52.8 (10.2) | 53.5 (11.1) | 53.2 (10.7) | 0.482 | 0.010 |
Charlson comorbidity index | |||||||||
mean (SD) | 0.2 (0.4) | 0.4 (0.6) | 0.3 (0.5) | 0.003 | 0.1 (0.4) | 0.2 (0.6) | 0.2 (0.5) | 0.009 | 0.399 |
TNM | |||||||||
0 | 0.0% | 0.0% | 0.0% | 0.138 | 0.0% | 0.0% | 0.0% | 0.141 | 0.969 |
1 | 5.1% | 4.2% | 4.6% | 5.0% | 4.3% | 4.6% | |||
2 | 32.7% | 31.7% | 32.1% | 33.7% | 32.5% | 33.0% | |||
3 | 59.2% | 47.5% | 52.8% | 57.4% | 45.3% | 50.9% | |||
4 | 3.1% | 16.7% | 10.6% | 4.0% | 18.0% | 11.5% | |||
Bilateral incidence | |||||||||
unilateral | 91.8% | 89.2% | 90.4% | 0.506 | 90.1% | 93.2% | 91.7% | 0.413 | 0.732 |
bilateral | 8.2% | 10.8% | 9.6% | 9.9% | 6.8% | 8.3% | |||
ER | |||||||||
positive | 59.2% | 53.3% | 56.0% | 0.387 | 57.4% | 52.1% | 54.6% | 0.434 | 0.773 |
negative | 40.8% | 46.7% | 44.0% | 42.6% | 47.9% | 45.4% | |||
HER2 | |||||||||
positive | 25.5% | 35.8% | 31.2% | 0.102 | 26.7% | 37.6% | 32.6% | 0.088 | 0.758 |
negative | 74.5% | 64.2% | 68.8% | 73.3% | 62.4% | 67.4% |
Groups | 1-Year Survival Rate (%) | 3-Year Survival Rate (%) | 5-Year Survival Rate (%) | Median Survival Time (Day) |
---|---|---|---|---|
MDT (2006–2016) | 98.5 | 81.6 | 65.6 | 1131 |
N-MDT (2006–2016) | 97.6 | 77.4 | 72.8 | 946 |
p value α | 0.475 | 0.285 | 0.097 | 0.126 |
Panel A | ||||
MDT (2006–2010) | 99.0 | 79.5 | 58.8 | 1785 |
N-MDT (2006–2010) | 99.0 | 82.2 | 78.7 | 2358 |
p value β | 0.983 | 0.643 | 0.004 | 0.001 |
Panel B | ||||
MDT (2011–2016) | 98.1 | 84.1 | 78.8 | 790 |
N-MDT (2011–2016) | 95.4 | 67.9 | 63.2 | 647 |
p value γ | 0.250 | 0.004 | 0.007 | 0.043 |
Variables | Hazard Ratio | 95% Confidence Interval | p Value |
---|---|---|---|
MDT*TIME | 0.1 | (0.064, 0.350) | <0.001 |
TNM | 1.7 | (1.293, 2.306) | <0.001 |
CCI | 1.0 | (0.598, 1.511) | 0.830 |
AGE | 1.0 | (0.992, 1.026) | 0.289 |
Bilateral incidence | 3.0 | (1.798, 5.038) | <0.001 |
ER | 0.5 | (0.312, 0.694) | <0.001 |
HER2 | 0.8 | (0.499, 1.185) | 0.234 |
TIME | 2.5 | (1.324, 4.558) | 0.004 |
MDT (TIME = 0) | 2.8 | (1.691, 4.539) | <0.001 |
Panel B | |||
MDT (TIME = 1) | 0.4 | (0.201, 0.834) | 0.014 |
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Lu, J.; Jiang, Y.; Qian, M.; Lv, L.; Ying, X. The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China. Int. J. Environ. Res. Public Health 2020, 17, 277. https://doi.org/10.3390/ijerph17010277
Lu J, Jiang Y, Qian M, Lv L, Ying X. The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China. International Journal of Environmental Research and Public Health. 2020; 17(1):277. https://doi.org/10.3390/ijerph17010277
Chicago/Turabian StyleLu, Jianlong, Yan Jiang, Mengcen Qian, Lilang Lv, and Xiaohua Ying. 2020. "The Improved Effects of a Multidisciplinary Team on the Survival of Breast Cancer Patients: Experiences from China" International Journal of Environmental Research and Public Health 17, no. 1: 277. https://doi.org/10.3390/ijerph17010277