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Multidisciplinary Approach in Comorbid Patients

Simona Panteleymonova, Ani Raynova, Radi Lukanov, Svetla Chilikova, Plamen Panayotov

Abstract

Introduction: Comorbidity is very common among patients with cancer and it is a real challenge to be treated. Multidisciplinary team (MDT) meetings are defined as a model for managing cancer in comorbid patients. The importance of communication between different specialists correlates with the effectiveness of the treatment and survival rate of patients.

Materials and Methods: The records of all patients were evaluated retrospectively. The preoperative evaluation for all patients included physical examination, laboratory tests, X-ray, ECG, echocardiography, and computed tomography.

Results: Our study presents 9 patients diagnosed with tumors, involving more than one organ and compressing adjacent organs. MDT approach was performed in all of them at the Department of Cardiac Surgery at the St. Marina University Hospital, Varna. Five of the patients were diagnosed with renal cell carcinoma, and one with papillary renal cell carcinoma. In one, a mediastinal cyst was found, another patient was diagnosed with mediastinal malignant carcinoid. One patients had a solitary fibrous tumor localized in right chest. In 8 of them median sternotomy was performed, in 1- mini-sternotomy, in 1- thoracotomy, in 1- bispinal transverse laparotomy, in 3 of them upper midline laparotomy with right transverse incision was performed; in 1- transverse right incision. The MDT meetings in 6 patients included a urologist, a vascular and a cardiac surgeon. In 3 other patients, the MDT approach involved a cardiac and a thoracic surgeon. All of the patients except one survived and were discharged. Resection of the tumor gives an opportunity for better results from target therapy.

Conclusion: Treatment in every patient and each disease is individual. The goal in carcinoma patients is to increase the therapeutic and surgical benefit and improve the quality of the patient’s life. Multidisciplinary approach in patients with this comorbidity is a necessary and effective treatment of choice.


Keywords

multidisciplinary team meetings, tumor, comorbidity


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