Association between preoperative multidisciplinary team discussion and survival outcomes in patients with colorectal cancer liver metastases undergoing initial hepatic resection: a single-center retrospective cohort study.

Authors

Yan Liu, Long Chen, Huachuan Song, Wei Cai, Ruipeng Song, Yongliang Zhang, Jizhou Wang

Published in

Chinese clinical oncology. Volume 15. Issue 5. Pages 65.

Abstract

Evidence regarding the association between multidisciplinary team (MDT) discussion and survival outcomes in patients with colorectal cancer liver metastases (CRLM) undergoing hepatic resection remains limited and inconsistent. This study aimed to evaluate the association between preoperative MDT discussion and survival outcomes in this surgically treated population.
We retrospectively analyzed consecutive patients with pathologically confirmed CRLM who underwent initial hepatic resection at our center between September 2020 and December 2024. Patients were categorized into MDT and non-MDT groups based on whether a preoperative MDT discussion was conducted. To improve balance in observed baseline characteristics, 1:1 propensity score matching (PSM) was performed. Overall survival (OS) was the primary endpoint, and recurrence-free survival (RFS) was analyzed as a secondary endpoint. Survival curves were estimated using the Kaplan-Meier method and compared with the log-rank test. Missing data were handled using multiple imputation (MI), and univariable and multivariable Cox regression analyses were performed to assess the association between MDT discussion and survival outcomes. Sensitivity analyses using complete-case multivariable Cox regression, Cox regression in the propensity score-matched cohort, and average treatment effect among the treated (ATT) weighting were performed to assess the robustness of the findings.
A total of 256 patients were included, including 79 in the MDT group and 177 in the non-MDT group. After 1:1 PSM, 72 matched pairs were identified. Before PSM, the MDT group had significantly better OS than the non-MDT group (P=0.03). The 1- and 3-year OS rates were 97.2% and 77.9% in the MDT group, compared with 88.8% and 57.5% in the non-MDT group, respectively. After PSM, the difference in OS remained significant (P=0.01), with corresponding 1- and 3-year OS rates of 98.5% and 77.9% versus 85.3% and 49.1%, respectively. No significant difference in RFS was observed before (P=0.52) or after PSM (P=0.16). In MI-pooled univariable Cox regression analysis, MDT discussion was associated with improved OS [hazard ratio (HR): 0.541; 95% confidence interval (CI): 0.301-0.975; P=0.04], and this association remained significant in multivariable analysis (HR: 0.483; 95% CI: 0.260-0.897; P=0.02). MDT discussion was not independently associated with RFS in multivariable analysis (HR: 0.928; 95% CI: 0.654-1.317; P=0.67). Sensitivity analyses using complete-case multivariable Cox regression, Cox regression in the propensity score-matched cohort, and ATT weighting yielded generally consistent results with the primary analysis.
Preoperative MDT discussion was associated with improved OS but not RFS in patients with CRLM undergoing initial hepatic resection. These findings support the potential value of MDT discussion in preoperative decision-making for this patient population.

PMID:
42988464
Bibliographic data and abstract were imported from PubMed on 06 Nov 2026.

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