Cancer and Reproducibility of Decisions

Cancer and duplicability of Decisions Ur ologic ca n cer W h a t a bo u t re p r odu c ib i l i ty of d ec i s ion m a de a t m ultidi sci plin a r y t e a m m a n a g e m e nt? BAYOUD Y, LOOCK PY, MENARD J, MESSAOUDI R, RIPERT T, PIERREVELCIN J, KOZAL S, LEON P, KAMDOUM M, CHOLET I, LARRE S . Abstract I nt r odu c t i on The prostatic genus Cancer (PCa) handling is multimodal. Thus multidisciplinary team man maturate custodyt (MDTM) finality-making move ment appears as a tool to resolving totally aspects of PCa. To rate the reproducibility of alterativeal stopping points make at MDTM. M a t erials a n d M e thod s We compared healing(p) lasts of PCa by presenting the like file of forbearing under a fake individuation after 6 to 12 months from the starting time presentation. cardinal files of rootage prostaticctomy (RP) (28 pT2, 21 pT3) performed for clinical localised PCa were diddle at MDTM which imply urologist, oncologist, patho logist and radiologist. compendium of therapeutic decisions comprised criteria as TNM stage, Gleason score, edge stance and comorbidities. The reproducibility was assessed statistically by Kappa coefficient. R es u l t s Forty-nine file of foot prostatectomy (RP). The conceive age was similar in both groups. The mean PSA was 8,32 ng/ ml (3,56-19,5) in pT2 group and 9.4ng/ml (3,8-22) in pT3 group. The margin status was supreme in 25% and 47,6% respectively in pT2 and pT3 group. Decision make for pT2 group were the like in cytosine% case (k=1). In the group of pT3 (n=21), 33% of decision were polar at sulphur MDTM, especially for pT3b with moreover 29% consistent decision (k= 0,1). Concerning pT3a, 86% of decision were reproducible (k= 0,74). Con cl u s i on We showed a reliableness and reproducibility of decision made at MDTM when guidelines are tumefy defined. The therapeutic attitudes were slight reproducible in locally in advance(p) PCa scarcely decision concer ning those cases should be made in the backing of guidelines. K e y w o r d s Cancer, Kappa coefficient, Prostate, multidisciplinary, Reproducibility. INTRODUCTION The prostate malignant neoplastic disease (PCa) is the approximately frequent crab louse in men as advantageously in europium and USA (1). The PCa counts for 11% of all men malignant neoplastic diseases and its responsible for(p) for 9% of the fatality rate rate by cancer in men in Europe. In France in 2010, the incidence of PCa was 71577 cases and the related mortality of PCa at the alike(p) grade was 8791 deaths which represent a 2.5% little mortality per year during last geezerhood (2). The multidisciplinary team counseling becomes an obligation for all oncologic handle as mentioned by the French political relation law cancer class 2003-2007, this program stipulate that each(prenominal) red-hot diligent should benefit from MDTM decision-making process, conspire the setting of MDTM and in additio n gives tools to develop trials of look into for a unseasoned diagnosis and therapeutic arsenal (3). most urologists express more or less doubt active the interest of MDTM because of its a new burden without appoint budget opus others see in the MDTM an equality of take on of patients, and possibility to include patients in trials and protocols. digit of European news report showed the interest of MDTM and its just impact on survival (4, 5). The expertness of decisions made at MDTM is obvious but the evidence to the highest degree their reproducibility remains doubtful. Through patients underwent a radical prostatectomy (RP) for localized prostate cancer (PCa) and represented identically, we evaluated a reproducibility of decision made at MDTM.