| Objective：Objective to explore the establishment and development process of multi-disciplinary outpatient service for gastrointestinal and colorectal cancer in our hospital,review the difficulties and shortcomings encountered in the early establishment of the outpatient service,analyze and summarize the work experience,and look forward to the development and future of multi-disciplinary outpatient service in our hospital.At the same time,to explore the application of multidisciplinary collaborative diagnosis and treatment model in the process of diagnosis and treatment of patients with advanced colorectal cancer,such as the improvement of auxiliary examination,the improvement of transformation efficiency,the enrichment of treatment methods,and the improvement of life quality and satisfaction of patients with unresectable initial diagnosis.Methods:the clinical data of 44 patients with advanced colorectal cancer from November2019 to November 2020 were retrospectively analyzed.The patients were divided into MDT group and non MDT group according to whether they were consulted by gastrointestinal and colorectal cancer multidisciplinary(MDT)clinic.After screening,20 patients and 24 patients were enrolled respectively.The related indexes of the two groups were compared.Basic indicators: age,gender,body mass index(BMI),smoking and drinking history,ECo G score,preoperative complications and the number of metastatic target organs.Follow up indicators: the follow-up methods include outpatient review or multi-disciplinary outpatient follow-up of gastrointestinal and colorectal cancer,telephone,and other communication tools.The content of follow-up mainly includes the completion rate of supplementary examination after MDT consultation;whether the treatment methods of patients with advanced colon cancer are more diversified(chemoradiotherapy,targeted therapy,interventional therapy,etc.)after MDT consultation;the successful transformation of potential resectable patients in advanced colorectal cancer;on the other hand,the content of follow-up It should also include the quality of life and the satisfaction of family members of patients who have been found unresectable in the early stage after multidisciplinary team consultation.The follow-up time was up to January 2021.Results:1.There was no statistical significance in age,gender,body mass index(BMI)and other general conditions of patients in MDT group and non MDT group(P > 0.05),so the two groups were comparable.The auxiliary examination of MDT group was more perfect than that of non MDT group.There was significant difference in the utilization rate of liver MRI,PET-CT and gene detection between the two groups(P < 0.05).In the MDT group,the treatment methods were more diverse [(2.2 ± 0.7)vs.(1.7 ± 0.6),t = 2.446,P< 0.01],and the consultation departments were more comprehensive [(4.8 ± 1.1)vs.(2.8 ± 1.2),t = 5.528,P < 0.01]For potential resectable patients with advanced colorectal cancer,75% and37.5% of MDT and non MDT patients received conversion therapy respectively(P <0.05),and 90% and 70.8% of MDT and non MDT patients received treatment satisfaction respectively(P < 0.05).There were significant differences in the proportion and satisfaction of the two groups.Conclusion:1.Compared with the non MDT group,the related auxiliary examinations such as liver MRI,PET-CT and gene detection of the patients consulted by MDT clinic in our hospital are more perfect,and the completion rate of auxiliary examinations is higher,which is conducive to the staging and grouping of patients,and better help the follow-up treatment of patients.2.The treatment plan of multi-disciplinary consultation is more comprehensive and diverse than that of traditional single disciplinary treatment(non MDT group).3.For patients with potentially resectable advanced colorectal cancer,the proportion of patients who received transformation therapy after multidisciplinary team consultation was higher.4.The quality of life of patients in MDT group was improved,and the treatment satisfaction of family members in MDT group was higher than that in non MDT group. |
