The impact of multidisciplinary team on surgical procedure and complications in duodenal tumor patients.

BACKGROUND: Local resection (LR) offers comparable prognosis to pancreaticoduodenectomy for benign and low-grade malignant duodenal tumors (DT). However, the LR rate remains low due to the difficulty in determining appropriate indications. This study aims to assess the impact of multidisciplinary team (MDT) on surgical procedure (SP) and complications in DT. METHODS: Clinical data from Centers A and B between 2019 and 2023 were analyzed. Utilizing the unique setting of Center A which operated both MDT and single-discipline treatment (SDT) pathways in parallel, we compared three cohorts: A-MDT, A-SDT, and B-SDT (from Center B). Following this comparison, a multivariate logistic regression analysis was performed, collapsing the groups into MDT and SDT categories to isolate its effect on outcomes. RESULTS: A total of 66 patients were included in study, with 22 patients in each group. The proportion of patients undergoing LR was 91% in A-MDT, 68% in A-SDT, and 55% in B-SDT, showing a statistical difference (P = 0.027). Furthermore, statistical differences were observed in length of hospital stay, length of postoperative hospitalization, duration of surgery, hemorrhage, bowel obstruction, major adverse events, Clavien-Dindo classification, and comprehensive complication index (P < 0.05). These results indicate that the MDT was superior to SDT. However, overall survival did not differ (P > 0.05). Multivariate logistic regression revealed that MDT was an independent predictive factor for lower comprehensive complication index (P = 0.008, OR = 5.13, 95% CI [1.59–18.61]), and SDT was an independent risk factor for selecting LR (P = 0.047, OR = 0.2, 95% CI [0.03–0.83]). Further analysis showed significantly higher rates of low-tension magnetic resonance imaging (Lt-MRI), endoscopic procedures involving the surgeon, and endoscopic local excisional biopsies in A-MDT, compared with A-SDT and B-SDT. CONCLUSION: The MDT enhances the selection of LR for patients with DT, reduces the incidence and severity of complications and accelerates patient recovery, with no impact on overall survival.