Abstract 1865P
Background
MTB is a valuable tool in complex cases, since they involve different medical fields aiming for comprehensive decision-making process. Our aims are to describe MTB decisions in complex LMCRC, to analyze decisions compliance and evaluate outcomes.
Methods
This is retrospective analysis of medical files of patients (PTS) diagnosed with LMCRC discussed at single center, weekly basis MTB from Jan 2019 to Dec 2020. Descriptive statistics was used for demographic and treatment characteristics and MTB decisions. Survival was estimated by Kaplan-Meier and log-rank test.
Results
Out of 1033 cases discussed at MTB, 63 met the inclusion criteria. Median age was 56.5yo (range 32 – 81), 61.9% were male, ECOG was 0-1 in 96.8%. Regarding sidedness: 81% and 19% were left and right respectively. Synchronous metastasis was present in 69.8% and wild-type RAS was found in 52.4% and MSI-H in 4.8%. At time of MTB, 68.3% and 4.8% had realized first or second-line chemotherapy (CT) respectively. No previous therapy was described in 19% and 7.9% had received adjuvant CT. Previous hepatic resections occurred in 20.6%. After MTB, liver resection was suggested for 44.5%. Preoperative CT followed by surgery for 23.8%. Non-surgical treatments were offered for 17.5% and palliative CT for 14.3%. Decisions from the MTB were implemented in 93.6%. Reason for not performing (N=4) were: one for disease progression, one for bureaucratic problems and two for other reasons. Median follow-up time was 17.2m. At date of analysis, 31 PTS (49.2%) had relapsed or progressed and 8 had died. Restricting for PTS who underwent MTB decision (N=59), mPFS was 14.71m. In resected cases (N=40), who were discussed at the onset of liver metastasis diagnosis (without CT in the metastatic setting) had mPFS not reached, while who were discussed after first or second-line had mPFS of 9.39m (p 0.002). R0 resections were reached in 92.5%. Evaluating the 30-day postoperative mortality, there was one death. mPFS for palliative CT was 6.83m.
Conclusions
In our analysis the adherence to, MTB recommendation was high and PTS selected for surgery presented a prolonged PFS. Our data suggest that selection of PTS for liver metastasis resection in a MTB discussion should occur early in the course of treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
AC Camargo Cancer Center.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.