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BACKGROUND: Elective treatment of colorectal cancer (CRC) is usually determined at a multidisciplinary team (MDT) conference. This practice has been registered in the Danish Colorectal Cancer Group database since 2010 and recommended in their guidelines since 2016. We aimed to investigate outcomes after MDT implementation. METHODS: We converted four nationwide observational health databases into a Common Data Model. We compared patients with and without an MDT discussion before CRC surgery using propensity score matching at a ratio of 1:1, and matched based on conditions at all times before surgery, procedures and observations 5 years before surgery, and medications 30 days before surgery. Outcomes were complications, return to intended oncological therapy (RIOT), mortality, and disease-free survival (DFS). RESULTS: We matched 3143 patients in each group who underwent elective surgery for CRC with curative intent between 2010 and 2019 and 995 patients from 2010 to 2019 eligible for adjuvant therapy. For RIOT at 90 days postoperatively, we calculated hazard ratios (HRs) of 1.04 (95% confidence interval CI 0.909-1.18) for the MDT group, 0.952 (95% CI 0.812-1.12) for 1-year mortality, and 0.951 (95% CI 0.868-1.04) for 5-year mortality. In the MDT group, the HR for DFS was 0.952 (95% CI 0.853-1.06), while the odds ratio (OR) for complications within 30 days of surgery was 0.982 (95% CI 0.676-1.43) and the OR for the proportion of patients receiving adjuvant therapy was 1.02 (95% CI 0.92-1.13). CONCLUSIONS: MDT discussions were not significantly associated with differences in short- and long-term outcomes.
Bräuner et al. (Tue,) studied this question.