Feasibility and Value of Establishing a Community-Based Virtual Multidisciplinary Sarcoma Case Conference

Abstract

PURPOSE: Management of soft tissue and bone sarcoma presents many challenges, both diagnostically and therapeutically, and requires multidisciplinary collaboration; however, such collaboration is often challenging to establish, especially in the community setting. We share our experiences of a virtual multidisciplinary sarcoma case conference (VMSCC). METHODS: We conducted retrospective review of the VMSCC data—initially via Webex, now Microsoft Teams—and the surveys of referring physicians to understand the feasibility and value of the VMSCC. RESULTS: The VMSCC was established in March 2013 in Kaiser Permanente Northern California with consistent participation of the Departments of Musculoskeletal Oncology (orthopedic oncology), Musculoskeletal Radiology, Pathology, Medical Oncology, Radiation Oncology, Nuclear Medicine, Surgical Oncology, and Genetics. Pediatric Oncology participated ad hoc when pediatric sarcoma cases were presented. Referrals were from multiple specialties and regions, including the Kaiser Permanente Mid-Atlantic and Hawaii regions. From March 2013 to December 2019, 1,585 cases were reviewed encompassing 36 histologic types. More than 300 cases were reviewed per year from 2017 to 2019. Survey results of referring physicians demonstrate that the VMSCC enhanced the confidence of treating physicians, and its recommendations frequently led to treatment changes. CONCLUSION: Establishing a valuable community-based VMSCC is feasible. VMSCC recommendations frequently led to treatment changes and improved the confidence of treating physicians.

Impact of a Virtual Multidisciplinary Sarcoma Case Conference on Treatment Plan and Survival in a Large Integrated Healthcare System

“…We previously published our experiences with a virtual multidisciplinary sarcoma case conference (VMSCC) from 2013 to 2019 with nearly 1,600 cases reviewed. 6 Our study showed that the majority of referring physicians felt that the VMSCC improved the quality of care and enhanced their confidence in treating patients with sarcoma. In addition, more than 50% of the responses in the most recent survey indicated that the VMSCC resulted in change of treatment plan very or somewhat frequently.…”

“…Our study may help multidisciplinary teams of various organizations in optimizing their care model to further enhance the value of their multidisciplinary approach. Minggui Pan, MD, PhD 1,2 ; Jeanette Yu, MD 3 ; Manpreet Sidhu, MD 4 ; Tiffany Seto, MD 5 ; and Andrew Fang, MD 6 abstract PURPOSE Quantifying the impact of a multidisciplinary cancer case conference on patient outcome and care quality remains challenging.…”

“…Our sarcoma group (referring to physicians only in this manuscript) was composed of the physicians who were regular participants of the VMSCC with special focus on the diagnosis and treatment of sarcoma, including medical oncologists, surgical oncologists, musculoskeletal oncologists, radiation oncologists, musculoskeletal radiologists, pathologists, nuclear medicine physician, and pediatric oncologists, with the support of nurse care coordinators and geneticists. 6…”

Can homogeneous, lipomatous tumors be primarily resected without biopsy? A retrospective analysis of 240 tumors

“…All surgical specimens must be marked according to their anatomical location and sent to pathology for histological analysis [ 40 ]. After pathological analysis, all cases with malignant tumors should be discussed in an interdisciplinary tumor conference after radiological tumor staging of the patient [ 15 ]. Complete resection should always be favored in all tumors [ 41 ].…”

“…Their response to chemotherapy is rather poor [ 13 ]. However, before resection, an interdisciplinary tumor conference is advised to discuss the individual therapy and a multimodal approach [ 14 , 15 ].…”