The impact of a multidisciplinary approach on treatment decisions and outcomes in urothelial carcinoma: A systematic review.
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Albers Acosta E, Pelari-Mici L, Celada Luis G, Velasco Balanza C, Zapatero A, Romero-Laorden N, Toquero Diez P, Caño-Velasco J, Guerrero-Ramos F, Moschini M, Krajewski W, Del Giudice F, Soria F, Laukhtina E, Mertens L, Pichler R, Mori K, D'Andrea D, Mari A, Marcq G, Teoh J, Afferi L, Albisinni S, Pradere B, Gallioli A, Subiela J D, San José Manso L, en representación del Grupo de Trabajo de Carcinoma Urotelial de la Sección de Jóvenes Urólogos Académicos - Asociación Europea de Urología (EAU-YAU)
Аннотация
MATERIALS AND METHODS: A systematic review was performed following PRISMA guidelines. We searched PubMed/Medline, Embase, Scopus and Cochrane databases for relevant studies on the role of multidisciplinary committees in the management of urothelial carcinoma, including bladder cancer, upper tract urothelial carcinoma and urethral carcinoma. Given the limited and heterogeneous evidence, a systematic review with narrative synthesis was performed.
RESULTS: Multidisciplinary tumor committees had a significant impact on the diagnosis and treatment of urothelial neoplasms, especially bladder cancer. Consistent findings showed that these committees produced substantial changes in treatment, improved adherence to clinical guidelines, and demonstrated a potential to improve patient outcomes. In addition, multidisciplinary committees increased the likelihood of curative treatments and were associated with reduced mortality rates, enhanced clinical decision making, and improved patient care, particularly in bladder and upper tract urothelial carcinoma.
CONCLUSIONS: This review highlights the essential role of multidisciplinary tumor committees in improving the management of urothelial carcinoma of the bladder and upper urinary tract. However, further research using standardized approaches is needed. The absence of studies on urethral carcinoma underlines the urgent need to investigate the potential benefits of multidisciplinary tumor committees. Future studies should cover a wider range of tumor types and follow standardized methodologies to provide a more complete and generalizable picture.