Keyword: Multidisciplinary Management
2 results found.
Congress Abstract
Oncology, Nuclear Medicine and Transplantology, 2(3, Suppl. 1), 2026, onmt_A28, https://doi.org/10.63946/onmt/19308
ABSTRACT:
Background: A multidisciplinary approach is an important component of high-quality cancer care, enabling collaborative decision-making on diagnostic and treatment strategies in accordance with clinical protocols and recommendations of international oncology societies. In accordance with the national Standard for the Organization of Cancer Care in the Republic of Kazakhstan, multidisciplinary teams (MDTs) covering the main areas of oncology have been established at the State Enterprise on the Right of Economic Management “Multidisciplinary Medical Center” of the Akimat of Astana.
Objective: To evaluate the organization of multidisciplinary team activities and their role in collaborative clinical decision-making in cancer care.
Materials and Methods: Six specialized MDTs were established: thoracic surgery, abdominal surgery, head and neck oncology, gynecologic oncology, urologic oncology, and medical oncology, along with a chemotherapy council. MDT meetings review newly diagnosed patients with histologically verified malignancies, patients with diagnostic challenges, recurrent or progressive disease, treatment-related complications or contraindications, and cases requiring modification of the treatment strategy. Decisions are made collaboratively based on medical records, diagnostic findings, clinical protocols, and recommendations of the European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), and National Comprehensive Cancer Network (NCCN). MDT protocols are continuously monitored for compliance with established requirements.
Results: In 2025, a total of 4,142 patient cases were reviewed at MDT meetings. The MDT process included collaborative selection of diagnostic and treatment strategies, determination of further patient management, assessment of the need to modify previously prescribed treatment, referral for specialized and highly specialized medical care, and evaluation of indications for targeted therapy. MDT decisions were documented in meeting protocols and incorporated into patients’ medical records. The established MDT process ensured systematic multidisciplinary review of clinical cases and continuous monitoring of clinical decisions.
Conclusions: The implementation of specialized multidisciplinary teams provides a structured framework for collaborative decision-making in cancer care and promotes a consistent approach to diagnostic and treatment strategies. Regular monitoring of MDT protocols supports compliance with established requirements. Further assessment using quantitative indicators of adherence to MDT recommendations, treatment modifications, and patient outcomes is warranted to objectively evaluate the impact of MDTs on the quality and outcomes of cancer care.
Objective: To evaluate the organization of multidisciplinary team activities and their role in collaborative clinical decision-making in cancer care.
Materials and Methods: Six specialized MDTs were established: thoracic surgery, abdominal surgery, head and neck oncology, gynecologic oncology, urologic oncology, and medical oncology, along with a chemotherapy council. MDT meetings review newly diagnosed patients with histologically verified malignancies, patients with diagnostic challenges, recurrent or progressive disease, treatment-related complications or contraindications, and cases requiring modification of the treatment strategy. Decisions are made collaboratively based on medical records, diagnostic findings, clinical protocols, and recommendations of the European Society for Medical Oncology (ESMO), American Society of Clinical Oncology (ASCO), and National Comprehensive Cancer Network (NCCN). MDT protocols are continuously monitored for compliance with established requirements.
Results: In 2025, a total of 4,142 patient cases were reviewed at MDT meetings. The MDT process included collaborative selection of diagnostic and treatment strategies, determination of further patient management, assessment of the need to modify previously prescribed treatment, referral for specialized and highly specialized medical care, and evaluation of indications for targeted therapy. MDT decisions were documented in meeting protocols and incorporated into patients’ medical records. The established MDT process ensured systematic multidisciplinary review of clinical cases and continuous monitoring of clinical decisions.
Conclusions: The implementation of specialized multidisciplinary teams provides a structured framework for collaborative decision-making in cancer care and promotes a consistent approach to diagnostic and treatment strategies. Regular monitoring of MDT protocols supports compliance with established requirements. Further assessment using quantitative indicators of adherence to MDT recommendations, treatment modifications, and patient outcomes is warranted to objectively evaluate the impact of MDTs on the quality and outcomes of cancer care.
Original Article
Oncology, Nuclear Medicine and Transplantology, 2(3), 2026, onmt025, https://doi.org/10.63946/onmt/19079
ABSTRACT:
Background: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the gastrointestinal tract. Their surgical management can be complicated by severe comorbidities, particularly advanced cardiovascular disease. We report a case of gastric GIST in a patient with ischemic cardiomyopathy, recurrent coronary interventions, and reduced ejection fraction, requiring implantable cardioverter-defibrillator (ICD) placement prior to tumor resection.
Case presentation: A 67-year-old man with a history of myocardial infarction, coronary artery bypass grafting, multiple percutaneous coronary interventions, and chronic heart failure presented with dyspnea, chest discomfort, and fatigue. During evaluation, an ulcerated gastric mass (cT3N0) consistent with GIST was identified. Echocardiography revealed an ejection fraction of 35–37% with apical aneurysm. Holter monitoring showed marked bradyarrhythmia and atrioventricular block. Given the high anesthetic risk, a multidisciplinary tumor board recommended initial cardiac optimization. The patient underwent implantation of a dual-chamber ICD (Biotronik Rivacor 5 MRI DR) and was stabilized with guideline-directed medical therapy and intermittent levosimendan infusion.
Outcome: Following optimization, the patient’s clinical status improved, with ejection fraction increasing to 37% and resting heart rate stabilized around 56 bpm. He subsequently underwent partial gastrectomy with duodenal anastomosis. Histology confirmed a low-risk GIST (M8936/3, <5 mitoses/50 HPF). The postoperative period was uneventful.
Conclusion: This case highlights the importance of a multidisciplinary, staged approach in managing oncological patients with advanced cardiovascular disease. Preoperative ICD implantation and optimization of heart failure therapy enabled safe surgical resection of gastric GIST.
Case presentation: A 67-year-old man with a history of myocardial infarction, coronary artery bypass grafting, multiple percutaneous coronary interventions, and chronic heart failure presented with dyspnea, chest discomfort, and fatigue. During evaluation, an ulcerated gastric mass (cT3N0) consistent with GIST was identified. Echocardiography revealed an ejection fraction of 35–37% with apical aneurysm. Holter monitoring showed marked bradyarrhythmia and atrioventricular block. Given the high anesthetic risk, a multidisciplinary tumor board recommended initial cardiac optimization. The patient underwent implantation of a dual-chamber ICD (Biotronik Rivacor 5 MRI DR) and was stabilized with guideline-directed medical therapy and intermittent levosimendan infusion.
Outcome: Following optimization, the patient’s clinical status improved, with ejection fraction increasing to 37% and resting heart rate stabilized around 56 bpm. He subsequently underwent partial gastrectomy with duodenal anastomosis. Histology confirmed a low-risk GIST (M8936/3, <5 mitoses/50 HPF). The postoperative period was uneventful.
Conclusion: This case highlights the importance of a multidisciplinary, staged approach in managing oncological patients with advanced cardiovascular disease. Preoperative ICD implantation and optimization of heart failure therapy enabled safe surgical resection of gastric GIST.