Association of multidisciplinary team meetings and survival in gastric cancer patients: nationwide cohort study.

BACKGROUND: Since 2015, multidisciplinary team (MDT) discussion is recommended for all Swedish patients diagnosed with gastric cancer. However, few studies have explored the association of MDT discussion with survival. METHODS: This study included all Swedish patients diagnosed with gastric adenocarcinoma between 2006 and 2021. Multivariable logistic regression was used to investigate the probability of receiving treatment recommendation at an MDT meeting, whereas the association between receiving an MDT treatment recommendation and overall survival was examined using Cox regression and Kaplan-Meier methods. RESULTS: Of 7813 patients, 5279 (68%) were discussed at an MDT meeting. Advanced age (80-89 years; odds ratio (OR) 0.30; 95% confidence interval (c.i.) 0.21 to 0.43) and lower performance status (Eastern Cooperative Oncology Group performance status 1; OR 0.68; 95% c.i. 0.56 to 0.81) were associated with a lower probability of receiving an MDT treatment recommendation. Clinical disease stages II and III, compared with stage I, were associated with a higher probability of an MDT discussion (OR 1.38 (95% c.i. 1.10 to 1.75) and 1.42; (95% c.i. 1.09 to 1.85), respectively), as was a later year of diagnosis (OR 1.37; 95% c.i. 1.35 to 1.40). In adjusted survival analysis with multivariable Cox regression, MDT discussion was associated with better survival (hazard ratio 0.89; 95% c.i. 0.83 to 0.95). In addition, median survival was longer in the group with than without MDT treatment recommendations (12.0 versus 5.9 months). CONCLUSION: Receiving a treatment recommendation at an MDT meeting was associated with better survival in patients with gastric adenocarcinoma. Patients with advanced disease and older age were less likely to receive an MDT treatment recommendation but, if they did, it was associated with better survival.