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multidisciplinary team therapy for left giant adrenocortical carcinoma: A case report

World Journal of Clinical Cases 2021年第20期9卷 5737-5743页

作者： Zheng Zhou Hong-Mei Luo Jian Tang Wu-Jun Xu Bin-Hui Wang Xu-Hui Peng Heng Tan Li Liu Xiang-Yang Long Yu-De Hong Xiao-Bin Wu Jian-Ping Wang Bai-Qi Wang Hai-Hui Xie Yong Fang Yong Luo Rong Li Yi Wang Department of Urology The Second Affiliated HospitalUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of Histology and Embryology Clinical Anatomy and Reproductive Medicine Application InstituteUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of Endocrinology The Second Affiliated Hospital of University of South ChinaHengyang 421001Hunan ProvinceChina Department of Oncology The Second Affiliated HospitalUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of Radiotherapy The Second Affiliated HospitalUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of Pathology The Second Affiliated HospitalUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of ICU The Second Affiliated HospitalUniversity of South ChinaHengyang 421001Hunan ProvinceChina Department of Clinical Pharmacy The Second Affiliated HospitalUniversity of South ChinaHengyang 421001Hunan ProvinceChina

BACKGROUND Adrenocortical carcinoma(ACC)is a rare malignant epithelial tumor originating from adrenocortical cells that carries a very poor *** or inoperable diseases are often considered incurable,and treatment remains a *** for advanced cases such as ACC complicated with renal venous cancer thrombus,there are few cumulative cases in the *** SUMMARY The patient in this case was a 39-year-old middle-aged male who was admitted to the hospital for more than half a month due to dizziness and chest *** tomography(CT)findings after admission revealed a left retroperitoneal malignant space-occupying lesion,but the origin of the formation of the left renal vein cancer thrombus remained to be *** was speculated that it originated from the left adrenal gland,perhaps a retroperitoneal source,and left adrenal mass+left nephrectomy+left renal vein tumor thrombus removal+angioplasty were performed under general *** pathology results indicated a diagnosis of *** steroid therapy was *** 3 mo after surgery,abdominal CT reexamination revealed multiple enlarged retroperitoneal lymph nodes and multiple low-density shadows in the liver,and palliative radiotherapy and mitotane were administered,considering the possibility of *** patient is currently being followed *** ACC is a highly malignant *** if the tumor is removed surgically,there is still the possibility of *** mitotane and adjuvant chemoradiotherapy have certain benefits for patients,but they cannot fully offset the poor prognosis of this disease.

关键词： Adrenocortical carcinoma Ki-67 multidisciplinary team Cancer thrombus Mitotane Case report

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Clinical application of multidisciplinary team-and evidence-based practice project in gynecological patients with perioperative hypothermia

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World Journal of Psychiatry 2023年第11期13卷 848-861页

作者： Qing-Yan Liu Tong-Yang You Dai-Ying Zhang Juan Wang The Operating Room The Affiliated Hospital of Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina

BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying ***,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with *** To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with *** Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice *** on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP *** incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the *** The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the *** implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001)

关键词： Hypothermia Gynecology Evidence-based care Knowledge translation multidisciplinary team

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Effect of multidisciplinary team treatment on outcomes of patients with gastrointestinal malignancy

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World Journal of Gastroenterology 2011年第15期17卷 2013-2018页

作者： Chang-Zheng Du Jie Li Yong Cai Ying-Shi Sun Wei-Cheng Xue Jin Gu Department of Colorectal Surgery Peking University School of Oncology Fucheng Road 52 Haidian District Beijing 100142 China Department of Medical Oncology Peking University School of Oncology Fucheng Road 52 Haidian District Beijing 100142 China Department of Radiotherapy Peking University School of Oncology Fucheng Road 52 Haidian District Beijing 100142 China Department of Radiology Peking University School of Oncology Fu Cheng Road 52 Haidian District Beijing 100142 China Department of Pathology Peking University School of Oncology Fucheng Road 52 Haidian District Beijing 100142 China

AIM: To evaluate the effect of multidisciplinary team (MDT) treatment modality on outcomes of patients with gastrointestinal malignancy in China. METHODS: Data about patients with gastric and colorectal cancer treated in our center during the past 10 years were collected and divided into two parts. Part 1 consisted of the data collected from 516 consecutive complicated cases discussed at MDT meetings in Peking University School of Oncology (PKUSO) from December 2005 to July 2009. Part 2 consisted of the data collected from 263 consecutive cases of resect-able locally advanced rectal cancer from January 2001 to January 2005. These 263 patients were divided into neoadjuvant therapy (NT) group and control group. Patients in NT group received MDT treatment, namely neoadjuvant therapy + surgery + postoperative adjuvant therapy. Patients in control group underwent direct surgery + postoperative adjuvant therapy. The outcomes in two groups were compared. RESULTS: The treatment strategy was altered after discussed at MDT meeting in 76.81% of gastric cancer patients and in 58.33% of colorectal cancer patients before operation. The sphincter-preservation and local control of tumor were better in NT group than in control group. The 5-year overall survival rate was also higher in NT group than in control group (77.23% vs 69.75%, P = 0.049). CONCLUSION: MDT treatment modality can significantly improve the outcomes of patients with gastrointestinal malignancy in China.

关键词： multidisciplinary team Rectal cancer Neo adjuvant radiotherapy Prognosis

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Impact of multidisciplinary team working on the management of colorectal cancer

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Chinese Medical Journal 2012年第2期000卷 172-177页

作者： Ye Ying-jiang Shen Zhan-long Sun Xian-tao Wang Zhi-feng Shen Dan-hua Liu Hui-jun Zhang Wan-lei Chen Ya-lin Zhou Jing Poston, G. J. Wang Shan Peking Univ Peoples Hosp Dept Surg Gastroenterol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Surg Oncol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Gastroenterol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Pathol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Radiol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Ultrason Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Radiotherapy Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Med Oncol Beijing 100044 Peoples R China Aintree Univ Hosp NHS Fdn Trust Dept Surg Liverpool L9 7AL Merseyside England

Background The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single *** cancer multidisciplinary team （MDT） working model is recommended by UK and other countries,but there is little information on the impact of MDT working on management of colorectal cancer in *** aim of this study was to assess the effect on management of colorectal cancer after the inception of an *** A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery,the pre-MDT cohort include 297 patients,recruited from January 1999 to November 2002,and the MDT cohort had 298 patients enrolled from December 2002 to September *** recorded included：TNM stage from histological reports,degree of differentiation,the number of examined lymph nodes and CT TNM staging performed or not,and its accuracy,including local and distant *** The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT *** TNM staging was more accurate in the MDT group compared to the pre-MDT group （P=-0.044）.The rate of tumor recurrence in the MDT group was lower than pre-MDT group （log-rank test,P 〈0.001）.Multivariate analysis revealed that age （P=0.001）,management after inception of the MDT （P=0.002）,degree of differentiation （P=0.003）,number of examined lymph nodes （P=0.002）,and TNM stage （P=0.000） were important factors that independently influence overall *** The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer *** working promoted communication and cooperation between disciplines and ensured high-quality diagnosis,evidence-based decision making,and optimal treatment planning.

关键词： colorectal cancer TNM stages computed tomography overall survival liver metastases multidisciplinary team chemotherapy surgery

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A temporary-sustainable team:A new multidisciplinary team model for severe trauma

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Chinese Journal of Traumatology 2020年第6期23卷 363-366页

作者： Xing-Ming Zhong Xiao-Hong Wen Chao-Hui Ji Xing-Zhen Fei Xiao-Gang Zhao Department of Emergency and Department of Neurosurgery The First People's Hospital of HuzhouFirst Affiliated Hospital of Huzhou Normal UniversityHuzhou 313000Zhejiang ProvinceChina Department of Emergency The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009Zhejiang ProvinceChina

The treatment of severe trauma,especially multiple injuries,requires multidisciplinary *** current study aims to highlight the challenges of consultation mode for severe trauma in general hospitals and emphasizes the need to create a new temporary-sustainable *** suggests developing an information consultation mode and enforcing the fine management to improve the quality and safety of the medical *** management mode of a temporary-sustainable team will reduce the cost and improve the treatment ***,a temporary-sustainable team has significant advantages over a traditional multidisciplinary team for severe trauma treatment.

关键词： Trauma Temporary-sustainable team multidisciplinary team

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Clinical and economic benefits of a pharmacist in a multidisciplinary team for Chinese outpatients with gastrointestinal stromal tumors

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Journal of Chinese Pharmaceutical Sciences 2021年第7期30卷 598-605页

作者： Yi Zhou Xingye Wu Juan Li Wei Cheng Xiaosong Li Yifan Shen Jun Zhang Department of Pharmacy the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Gastrointestinal Surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China The Center for Clinical Molecular Medical Detection the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

The multidisciplinary approach is beneficial to the treatment of gastrointestinal stromal tumors(GISTs).However,pharmacists are seldom incorporated into a multidisciplinary team(MDT)of *** the present study,we evaluated the clinical and economic benefits of a pharmacist in an MDT of *** was a retrospective study that included 240 GIST patients receiving imatinib *** GIST MDT pharmacist developed and validated an HPLC method to monitor the trough concentrations of imatinib in GIST ***,the pharmacist also provided patient education and pharmaceutical care services and collected the data for *** 240 GIST patients received the services provided by the *** trough concentrations in 25.42%of the 240 patients were less than 1100 ng/m *** main genotypes of 121 in the 240 patients were KIT exon 11 mutations,wild type,and KIT exon 9 ***,13 GIST patients with trough concentrations less than 1100 ng/m L were confirmed to have low *** adverse reactions were primarily mild and tolerable,except that 13 GIST patients were adjusted to lower doses because of the intolerable adverse *** daily cost could be lowered by monitoring the trough concentrations and dose ***,a pharmacist included in a GIST MDT could increase the compliance of Chinese GIST patients to imatinib therapy and improve the efficacy,safety,and economy of imatinib therapy.

关键词： Pharmacist Imatinib multidisciplinary team Gastrointestinal stromal tumor Trough concentration

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Clinical application of multidisciplinary teams in tumor therapy

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Chinese Journal of Cancer Research 2017年第2期29卷 168-170页

作者： Cong Wang Dongjian Song Zhili Xu Jiaxiang Wang School of Humanities and Social Sciences Beihang University Department of Pediatric Surgery the First Affiliated Hospital of Zhengzhou University

multidisciplinary team （MDT） model is a diagnostic and treatment model characterized by interdisciplinarity, integration, centralism, individualization, and precision and is becoming more common in the management of complex malignancies. MDT emphasizes team spirit and a personalized treatment strategy according to the actual condition of each patient. A cooperative and effective multidisciplinary team is an important guarantee for delivering high-quality services to patients. Under the guidance of a medical humanistic concept, MDT provides reasonable, effective, convenient, and a full range of excellent quality medical service to patients. The MDT maximizes patient benefits, and it is the developmental direction for large-scale general hospitals. At the same time, the MDT is also an important measure to strengthen the core competitiveness of hospitals. Here, we introduce the clinical application of the model in tumor therapy as well as the current state and development in our hospital.

关键词： multidisciplinary team tumor therapy clinical application

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multidisciplinary discussion and management of synchronous colorectal liver metastases: A single center study in China

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World Journal of Gastrointestinal Oncology 2023年第9期15卷 1616-1625页

作者： Hao Li Guo-Li Gu Song-Yan Li Yang Yan Shi-Dong Hu Ze Fu Xiao-Hui Du Graduate School Medical School of Chinese People’s Liberation ArmyBeijing 100039China Department of General Surgery Air Force Medical CenterAir Force Medical UniversityBeijing 100142China Department of General Surgery Chinese People’s Liberation Army General HospitalBeijing 100039China

BACKGROUND The multidisciplinary team(MDT)has been carried out in many large hospitals ***,given the costs of time and money and with little strong evidence of MDT effectiveness being reported,critiques of MDTs *** To evaluate the effects of MDTs on patients with synchronous colorectal liver metastases and share our opinion on management of synchronous colorectal liver *** In this study we collected clinical data of patients with synchronous colorectal liver metastases from February 2014 to February 2017 in the Chinese People’s Liberation Army General Hospital and subsequently divided them into an MDT+group and an *** total,93 patients in MDT+group and 169 patients in MDT-group were included *** Statistical increases in the rate of chest computed tomography examination(P=0.001),abdomen magnetic resonance imaging examination(P=0.000),and preoperative image staging(P=0.0000)were observed in patients in MDT+***,the proportion of patients receiving chemotherapy(P=0.019)and curative resection(P=0.042)was also higher in MDT+*** analysis showed that the population of patients assessed by MDT meetings had higher 1-year[hazard ratio(HR)=0.608,95%confidence interval(CI):0.398-0.931,P=0.022]and 5-year(HR=0.694,95%CI:0.515-0.937,P=0.017)overall *** These results proved that MDT management did bring patients with synchronous colorectal liver metastases more opportunities for comprehensive examination and treatment,resulting in better outcomes.

关键词： Synchronous colorectal liver metastases multidisciplinary team Imaging examination Treatment strategy Oncological outcome

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multidisciplinary comprehensive treatment of massive hepatocellular carcinoma with hemorrhage:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2225-2232页

作者： Xian-Shuai Kou Fan-Fan Li Yun Meng Jian-Ming Zhao Sheng-Fen Liu Lan Zhang The First Clinical Medical College Gansu University of Chinese MedicineLanzhou 730000Gansu ProvinceChina Department of Thoracic Surgery The First Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Department of Surgery Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina Department of Orthopedics Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina

BACKGROUND Hepatocellular carcinoma(HCC),a major contributor to cancer-related deaths,is particularly prevalent in Asia,largely due to hepatitis B virus *** prognosis is generally *** case report contributes to the medical literature by detailing a unique approach in treating a large HCC through multidisciplinary collaboration,particularly in patients with massive HCC complicated by ruptured bleeding,a scenario not extensively documented *** SUMMARY The patient presented with large HCC complicated by intratumoral *** involved a multidisciplinary approach,providing individualized *** strategy included drug-eluting bead transarterial chemoembolization,sorafenib-targeted therapy,laparoscopic partial hepatectomy,and standardized sintilimab monoclonal antibody *** months after treatment,the patient achieved complete radiological remission,with significant symptom *** studies showed no lesions or recurrence,and clinical assessments confirmed complete *** report is notable as possibly the first docu-mented case of successfully treating such complex HCC conditions through integrated multidisciplinary efforts,offering new insights and a reference for future similar *** This study demonstrated effective multidisciplinary treatment for massive HCC with intratumoral bleeding,providing insights for future similar cases.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Sintilimab Sorafenib Translational therapy multidisciplinary team Case report

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Management of retroperitoneal sarcoma involving the iliac artery:Single-center surgical experience

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World Journal of Clinical Cases 2022年第3期10卷 811-819页

作者： Wen-Xiang Li Han-Xing Tong Chen-Tao Lv Hua Yang Gang Zhao Wei-Qi Lu Yong Zhang Department of General Surgery Shanghai Public Health Clinical CenterFudan UniversityShanghai 200083China Department of General Surgery Zhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND Management of retroperitoneal sarcoma(RPS)involving the iliac artery is challenging and requires the concerted efforts of multidisciplinary team(MDT)members during surgical *** To summarize the clinicopathologic features of RPS involving the iliac artery and our retroperitoneal soft tissue tumor MDT surgical *** In this retrospective study,15 patients with RPS involving the iliac artery who underwent surgery at our retroperitoneal soft tissue tumor center from July 2004 to June 2020 were *** analyses were performed by Student’s ttest with SPSS *** Complete tumor resection(R0/R1)and iliac artery reconstruction were achieved in all 15 *** the operations were successful,with no serious complications or perioperative *** with bilateral iliac artery reconstruction required a higher intraoperative blood transfusion volume than resection with unilateral iliac artery *** cases were more likely to bleed and required a higher blood transfusion volume than primary *** of January 2021,11 patients were alive,and 4 had *** recurrence occurred in two patients,one of whom developed liver *** Resection of RPS involving iliac vessels is feasible and effective when performed by MDT *** artery oncovascular resection and reconstruction are key to a successful *** blood preparation is important for successful completion of surgery.

关键词： Retroperitoneal sarcoma Vascular reconstruction multidisciplinary team Iliac artery Blood transfusion

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