Purpose: The prostate cancer (PCa) treatment is multimodal. Thus Multidisciplinary team management (MDTM) decision-making process appears as a tool to answer all aspects of PCa treatment. Our aim was to evaluate the reproducibility of therapeutic decisions made at MDTM. Materials and Methods: We compared therapeutic decisions of PCa by presenting the same file of patient under a fake identity after 6 to 12 months from the first presentation. Forty-nine files of radical prostatectomy (RP) (28 pT2, 21 pT3) performed for clinical localized PCa were represented at MDTM which included urologist, oncologist, pathologist and radiologist. Analysis of therapeutic decisions comprised criteria such as: TNM stage, Gleason score, margin status and comorbidities. The reproducibility was assessed statistically by Kappa coefficient. Results: Study subjects included 49 patients who underwent radical prostatectomy (RP). The mean age was similar in pT2 and pT3 groups (P =. 09). The mean serum PSA value was 8. 32 ng/mL (range, 3. 56-19. 5) in pT2 group and 9. 4 ng/mL (range, 3. 8-22) in pT3 group. The margin status in pT2 and pT3 groups was positive in 25. 0% and 47. 6%, respectively. The decisions made at first and second MDTM for pT2 group were the same in 100% of cases with a perfect kappa coefficient (k = 1). In the group of pT3 (n = 21), the decisions were different in 33% at the second MDTM in comparison to the first MDTM. Especially for pT3b only 29% were reproducible decision with a slight agreement (k = 0. 1). Concerning pT3a, 86% of the decisions were reproducible with a substantial agreement (k = 0. 74). Conclusion: We showed a reliability and reproducibility of decision made at MDTM when guidelines are well defined. The therapeutic attitudes were less reproducible in locally advanced PCa but decision concerning those cases should be made in the setting of guidelines.

Background: Post-mastectomy radiation therapy (PMRT) is a key component in managing breast cancer with increased potential for locoregional recurrence. Breast reconstruction has evolved to include various techniques that can be categorized according to the type of reconstruction (implant-based versus autologous reconstruction), and the timing of reconstruction (one versus two-step techniques). Methods/Results: This review article aims to provide a digestible summary of PMRT in the context of breast reconstruction by summarizing salient existing literature with a focus on considerations of the plastic surgeon. The main findings summarized in this review include the technique and timing of breast reconstruction, how breast reconstruction can affect radiation delivery, and the type of reconstruction. Within implant-based reconstruction, existing data on the location of the implant in the context of PMRT and PMRT delivery to the tissue expander versus permanent implant are reviewed. Each consideration may alter the probability of successful reconstruction and patient satisfaction. Conclusion: It is essential for the Multidisciplinary breast cancer team to have knowledge of the various reconstructive options, and to understand the safety and comparative effectiveness of staged reconstruction in the setting of PMRT. Additionally, one must consider that reconstructive procedures may have implications on the timely administration of PMRT. This review serves as a reference for members of the oncologic care team when discussing reconstructive options with patients who will receive PMRT as part of their treatment plan.

Background: Liver cancer and cirrhosis are significant public health challenges with a high global burden. Multidisciplinary team (MDT) care has gained recognition as a promising approach to improve the management and outcomes of patients with liver cancer and cirrhosis. We aimed to evaluate the effectiveness of MDT care in improving the clinical outcomes, including survival rates, quality of life, and disease progression, in patients with liver cancer and cirrhosis. Methods: The search was performed using the keywords of liver cancer and MDT and their combinations in international databases with a time limit for publishing articles from 2010 and 2023. The data were evaluated using a technique of meta-analysis as well as a model called random effects. The I2 test was used to examine the degree of heterogeneity between the studies. STATA was used to analyze the data. Results: The analysis of 13 different papers with a total sample size of 8641 individuals revealed that the average scores of the MDT and liver cancer were identical to (0.64), with a confidence interval ranging from (95% 48.5-81.7). Conclusion: MDT is effective in the length of treatment and reduction of risk and mortality rates. The negative prognostic factors of not following the MDT decision were not observed.

Background: When breast cancer is diagnosed during pregnancy or within the first year after delivery, the condition is named as pregnancy-associated breast cancer (PABC). Breast cancer during pregnancy is a devastating situation for the patient, her family, and the medical team. Providing guidance for diagnosis and treatment of PABC, we report a case along with review of the literature. Case presentation: Here we present a 31-year-old pregnant woman with low back pain who was referred to the gynecology ward. She was at 25 weeks and 6 days pregnancy. After workup, it was discovered that she had a lytic lesion in her spine. Further workup revealed that she had metastatic breast cancer with the pathology of invasive ductal carcinoma. After consultation with a Multidisciplinary team (a gynecologist, an oncologist, a radiotherapist, a hematologist-oncologist, and a neurosurgeon), we terminated the pregnancy and put her on radiotherapy for the spine metastasis and systemic therapy. Also, we reviewed 36 pregnant patients with primary or recurrent breast cancer who were managed with outpatient chemotherapy, surgery, or surgery plus radiation therapy. Care was provided by medical oncologists, breast surgeons, and perinatal obstetricians. Conclusion: Since there are no sufficient data in the literature to guide the development of standard protocols for management of PABC patients (specially in metastatic disease), pregnant women must be followed up by a Multidisciplinary team, and each case should be managed considering the gestational age and the stage of cancer.