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1 Section of Surgery and Internal Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet 2 unknown 3 Section of Diagnostic Sciences, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet 4 Section of Surgery and Internal Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet 5 Section of Diagnostic Sciences, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
Aim: In 2003 colorectal multidisciplinary teams (MDT) were established in all major Danish hospitals treating colorectal cancer. The aim was to improve the prognosis by a multidisciplinary evaluation and decision about surgical and oncological treatment, based on medical history, clinical examination, imaging, histology, and comorbidity.The present study evaluated the effect of the introduction of colorectal MDT on 1.8.2004 in two Danish hospitals. Method: A retrospective cohort study was conducted comparing the outcome during the last three years before introduction of the MDT with the first two years after (the MDT cohort).. The national colorectal cancer database, with follow-up recorded by the National Patient Registry in September 2010 was used. The endpoints included the incidence of preoperative radiochemotherapy (RCT) offered according to the national guidelines, R0/R1/R2 resection, postoperative mortality, local recurrence, distant recurrence and over-all and disease-free survival. Results: 811 patients were diagnosed with primary rectal cancer in Hvidovre and Bispebjerg Hospitals 1.5.2001-31.8.2006. The frequency of preoperative MRI scans increased in the MDT cohort and perioperative mortality decreased. More metachronous distant metastases were found in the MDT cohort but there was no difference in overall survival. Conclusion: There was an improved postoperative mortality but no other potential benefits for the patients were seen after the implementation of the MDT. © 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of GreatBritain and Ireland.
Colorectal Disease, 2013, Vol 15, Issue 4, p. 410-413
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