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The impact of adrenal tumor multidisciplinary team meetings on clinical outcomes

  • Clinical Management of Endocrine Diseases
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

Multidisciplinary team meetings (MDMs) to address various clinical problems have become common, especially for cancer care. However, the impact of MDMs on adrenal tumor care has rarely been reported. We organized an endocrine tumor MDM including adrenal tumors in August 2014. The objective of this study was to assess the impact of our adrenal tumor MDMs on patient clinical outcomes. We compared several parameters measuring clinical outcomes before and after MDMs were instituted.

Methods

The adrenal tumor MDMs included an endocrinologists, urologists, radiologists, pathologists, and residents. We analyzed 128 consecutive cases of functioning adrenal tumors (primary aldosteronism (PA), n = 53; Cushing’s syndrome (CS), n = 24; pheochromocytoma (PCC), n = 51) who underwent surgery in Kobe University Hospital from 2008 to 2019, and compared clinical parameters before (n = 68) and after (n = 60) MDMs were instituted.

Results

Twenty-one selected cases including PA, CS, PCC, adrenocortical carcinoma, and metastatic adrenal tumor were discussed in the MDM. In the analysis of 128 cases, the difference between pre- and postoperative systolic BP (ΔBP) in patients with PA after MDMs were instituted was smaller compared with those before (p = 0.02). In CS, preoperative steroid synthesis inhibitors were used more often (33 vs. 100%, p < 0.01), postoperative plasma ACTH levels were higher (29.1 vs. 84.5 pg/mL, p < 0.01), and postoperative decrease in systolic BP was milder (p < 0.01) after MDMs were instituted. In PCC, doses of preoperative doxazosin were higher (p < 0.01) after MDMs institution. Operating time, bleeding volume, and cure rate did not differ between each tumor type.

Conclusions

These data suggest that instituting MDMs improved the perioperative management of functioning adrenal tumors.

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Acknowledgements

We are grateful to Ms. Y. Souki, Ms. M. Sakoda, and Dr. M. Kimura-Koyanagi for providing excellent assistance.

Funding

Grant-in-Aid for Scientific Research from the Japanese Ministry of Education, Culture, Sports, Science and Technology 15K09432 (K.S.), 19K09003 (H.F.).

Author information

Authors and Affiliations

  1. Division of Diabetes and Endocrinology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Hidenori Fukuoka & Masaaki Yamamoto

  2. Division of Urology, Department of Organ Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Katsumi Shigemura, Mariko Sakamoto & Masato Fujisawa

  3. Department of Public Health, Kobe University Graduate School of Health Science, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan

    Katsumi Shigemura & Koichi Kitagawa

  4. Department of Diagnostic Pathology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, CKobe, 650-0017, Japan

    Maki Kanzawa

  5. Department of Radiology, Kobe University School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Tomonori Kanda

  6. Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Koichi Kitagawa

  7. Medical Center for Student Health, Kobe University, Kobe, Hyogo, Japan

    Genzo Iguchi

  8. Department of Biosignal Pathophysiology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Genzo Iguchi

  9. Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Wataru Ogawa & Yutaka Takahashi

Authors
  1. Hidenori Fukuoka
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  2. Katsumi Shigemura
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  3. Maki Kanzawa
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  4. Tomonori Kanda
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  5. Masaaki Yamamoto
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  6. Koichi Kitagawa
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  7. Mariko Sakamoto
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  8. Genzo Iguchi
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  9. Wataru Ogawa
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  10. Masato Fujisawa
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  11. Yutaka Takahashi
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Contributions

H.F., K.S., Y.T. conceived the idea and design for this study. H.F. prepared the draft of the paper with assistance from K.S., W.O., M.F., and Y.T. M.K., T.K., M.Y., K.K., M.S., and G.I. contributed to the study design and provided clinical expertise throughout the project.

Corresponding author

Correspondence to Katsumi Shigemura.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Research Ethics Committee of Kobe University Hospital (IRB# 1351).

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Fukuoka, H., Shigemura, K., Kanzawa, M. et al. The impact of adrenal tumor multidisciplinary team meetings on clinical outcomes. Endocrine 69, 519–525 (2020). https://doi.org/10.1007/s12020-020-02361-x

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  • DOI: https://doi.org/10.1007/s12020-020-02361-x

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