72277 - Multidisciplinary treatment decision associated with improved survival in gastric cancer patients; a nationwide cohort study in 7818 patients

Introduction Gastric cancer has an age-standardized annual incidence rate of 8-9 cases per 100,000 population in Sweden, often diagnosed in a late stage requiring complex treatment strategies. The aim was to study and evaluate the effect of multidisciplinary conferences (MDC) on survival in Swedish gastric cancer patients from 2006-2021. Method A retrospective cohort study of 7818 patients identified in the national registry for esophageal- and gastric cancer (NREV) was performed. Survival outcomes were compared using Kaplan-Meier method and Cox proportional hazards models adjusted for clinical and demographic variables identified with a directed acyclic graph. Result In 5282 (68%) patients treatment recommendation was made at an MDC, rising from 20% in 2006 to 90% in 2021. Median follow-up was 9.5 months. 6510 patients were included in multivariate analysis. MDC patients had improved survival (hazard ratio (HR) = 0.89, 95% CI 0.83-0.95, p=0.001), similarly found in subgroup analysis of patients older than 80 years (HR = 0.82, 95% CI 0.73-0.92, p=0.001), low performance status (ECOG 3-4, HR = 0.63, 95% CI 0.54-0.74, p<0.001) and late-stage disease (stage IV, HR = 0.91, 95% CI 0.84-0.98, p=0.012), Figure 1. Discussion MDC-guided treatment decisions is positively associated with increased survival in gastric cancer patients. This effect persists when looking at characteristics traditionally excluding patients from MDC (i.e. age >80, low performance status and advanced disease). The results suggest that more patients might benefit from insights at MDCs.