National Cancer Grid Virtual Tumor Boards of Head and Neck Cancers: An Innovative Approach to Multidisciplinary Care

Abstract

PURPOSE Virtual tumor board (VTB) via videoconference facility involving multiple specialists in the decision making for various tumors is well accepted, especially in high-income countries. Information on virtual tumor boards for head and neck cancers especially from low- and middle-income countries is sparse. In this study, we have audited the findings of the National Cancer Grid VTBs performed for head and neck cancers. METHODS All patients discussed in the head and neck VTBs at our center between December 2016 and February 2022 were included in the study. Details such as the type of institute sending patients for discussion, its location, subsites within the head and neck region, histopathology, treatment setting or question for the VTB, and availability of guidelines for such patient scenarios were assessed. Also, a survey was sent to assess the usefulness of the VTBs. RESULTS A total of 208 patients were discussed in 54 VTB sessions. The most common head and neck sites discussed in the VTBs were the oral cavity (n = 64, 30.7%) followed by skull base/nose and paranasal sinuses/eyelid-orbit tumors (n = 49, 23.5%). Nonsquamous cell carcinoma was the most common histopathology discussed; recurrent cancers/residual diseases were the most common treatment settings (n = 134, 64.4%) for which there were no existing guidelines. Survey results showed that most VTB decisions were implementable, and respondents felt that VTBs were a useful educational tool as well. CONCLUSION Our study affirms the feasibility of VTBs in low- and middle-income countries' health care systems for managing uncommon malignancies and clinical situations, which act as an important educational platform.

Inequities in global cancer surgery: Challenges and solutions

“…The National Cancer Grid in India has demonstrated the power of this approach to improving access to multidisciplinary decision making particularly for uncommon cancers at a national level, and the value of virtual tumor boards as an educational tool for both trainees and practicing surgeons and physicians. 36 The use of virtual tumor boards has accelerated globally during the COVID-19 pandemic and is now also more common in HICs. Telepathology and teleradiology are two other technology-based approaches that can strengthen cancer care delivery and provide a mechanism for training locally where expertise in an area is lacking.…”

“…Virtual tumor boards, conducted at a local, regional or international level to support surgeons working outside of major cancer centers allow for access to multidisciplinary expertise that may not be available locally, and shared decision making on recommended treatment and treatment sequencing. The National Cancer Grid in India has demonstrated the power of this approach to improving access to multidisciplinary decision making particularly for uncommon cancers at a national level, and the value of virtual tumor boards as an educational tool for both trainees and practicing surgeons and physicians 36 . The use of virtual tumor boards has accelerated globally during the COVID‐19 pandemic and is now also more common in HICs.…”

How well does the virtual format of oncology multidisciplinary team meetings work? An assessment of participants’ perspectives and limitations: A scoping review

“…We discovered a total of 36 papers using our search criteria. The number of studies at each stage of the screening process is shown in Fig 1 . Study designs of included studies were mostly observational cross-sectional studies (n = 15) [7,[17][18][19][20][21][22][23][24][25][26][27][28][29][30]. Other study designs were retrospective review of records with a cross-sectional survey (n = 12) [5,[31][32][33][34][35][36][37][38][39][40][41], meeting observations with cross-sectional survey (n = 1) [42], mixedmethod design (n = 3) [43][44][45], embedded study design (n = 1) [46], randomized controlled trials (n = 2) [47,48], descriptive qualitative synthesis using free-text cross-sectional surveys (n = 1) [49], and an anthropological analysis (n = 1) [50].…”

“…Decision-making. Two studies reported that consensus was frequently reached in VMDTMs [20,35], and, according to one study, there is no difference between IMDTMs and VMDTMs in reaching a consensus [46]. However, one study reported that the level of consensus was slightly lower for VMDTMs compared to in-person meetings [48].…”

“…A total of 12 studies commented on patient-related aspects of VMDTMs [17,18,20,23,27,30,36,37,41,42,46,49].…”