The impact of a multidisciplinary tumour board (MDTB) in the management of colorectal cancer (CRC)

• Published in: Clinical colorectal cancer 2025-01
• Main Authors: Schietroma, Francesco, Bensi, Maria, Calegari, Maria Alessandra, Pozzo, Carmelo, Basso, Michele, Valente, Giustina, Caira, Giulia, Trovato, Giovanni, Spring, Alexia, Beccia, Viria, Ceccarelli, Anna, Perazzo, Serena, Chiofalo, Laura, Barbaro, Brunella, Tatulli, Giulia, Alfieri, Sergio, De Sio, Davide, Lorenzon, Laura, Persiani, Roberto, Lococo, Filippo, Nachira, Dania, Giuliante, Felice, Ardito, Francesco, Cellini, Francesco, Panza, Giulia, Cozza, Valerio, Giovinazzo, Francesco, Pafundi, Donato Paolo, Sofo, Luigi, Santullo, Francesco, Tondolo, Vincenzo, Tortora, Giampaolo, Salvatore, Lisa
• Format: Article
• Language: English
• Subjects: Colorectal cancer; imaging reviewing; multidisciplinary tumour board; radiotherapy; surgery
• ISSN: 1533-0028
• DOI: 10.1016/j.clcc.2025.01.002

The management of colorectal cancer (CRC) is a complex process. Defining the disease burden, assessing the radiological response and identifying the right time for surgery or other locoregional treatments are crucial factors which can require the involvement of a multidisciplinary tumour board (MDTB) comprising several specialists. This study investigates the impact of MDTB on management of CRC in our institution. We retrospectively assessed all cases discussed by our MDTB between September 2019 and April 2023. In particular, we collected data concerning radiology, surgery and radiotherapy indication before and after MDTB meetings. The primary endpoint was the overall rate of discrepancy between pre- and post-discussion evaluations. Our analysis involved 1150 cases. Median age was 64 years (16-90), 629 patients (54.7%) were male and 915 (79.5%) had metastatic disease at the time of the relevant MDTB discussion. After the meetings, 325 treatment decisions were modified, producing an overall discrepancy rate of 28.3%. In particular: (a) of 648 cases discussed for radiological assessment, 156 decisions (24.1%) were altered after a central imaging review; (b) of 327 cases considered for surgical approach, treatment strategy changed in 118 (36.1%); and (c) of the 160 cases discussed regarding radiotherapy, the treatment strategy changed in 51 of them (31.9%). Our analysis shows significant discrepancies between the radiology and locoregional evaluations from both before and after the MDTB meetings. Our results highlight that the discussions of a MDTB can considerably change the management of CRC, maximising the treatment strategy. Management of colorectal cancer is complex and can require a multidisciplinary tumour board discussion. We assessed 1150 cases discussed between September 2019 and April 2023 in our institution, collecting data concerning radiology, surgery and radiotherapy indication before and after meetings. An overall discrepancy rate of 28.3% was detected after meeting, with 325 changes between pre- and post-MDTB discussion.