Tumor Board Participation Among Physicians Caring for Patients With Lung or Colorectal Cancer

Kehl, Kenneth L.; Landrum, Mary Beth; Kahn, Katherine L.; Gray, Stacy W.; Chen, Aileen B.; Keating, Nancy L.

doi:10.1200/jop.2015.003673

Cited by 55 publications

(53 citation statements)

References 22 publications

(11 reference statements)

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“…Three formats for MTP were observed. Conference formats (n = 20) convened various disciplines to review cases and reach a consensus about overall management. Activities included reviewing pathology, molecular, or imaging studies; confirming or adjusting diagnosis or staging; determining the adequacy of surgical treatment; recommending additional testing; and finalizing a treatment plan.…”

Section: Resultsmentioning

confidence: 99%

“…The diverse range of outcomes examined across studies is presented in Table . Table summarizes the outcome data with studies grouped according to MTP delivery format and disease site. Sixteen of 19 studies demonstrated an association between MTP and receipt of guideline‐concordant treatment.…”

Section: Resultsmentioning

confidence: 99%

“…There was heterogeneity in the approach to survival analysis, and variation in both the length of follow‐up and whether covariates such as age and disease stage were included in the modeling. Six of 7 studies that did not demonstrate an association with survival were underpowered.…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of multidisciplinary treatment planning in US cancer care settings

Das

Baker

Altice

et al. 2018

Cancer

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Multidisciplinary treatment planning (MTP) is a process of engaging multiple disciplines to develop or refine the disease management plan. It is widely implemented in US cancer treatment settings and is considered to have favorable effects on both care quality and other outcomes. However, evidence reviews to date regarding MTP effectiveness have based their conclusions on studies conducted predominantly outside the United States. The authors conducted a systematic review of US-based studies to synthesize and critically appraise evidence of the effects of MTP on cancer care quality, health services outcomes, and survival. Database searches identified studies of MTP outcomes conducted in US cancer care settings from 2000 to 2017. Forty-five studies met criteria for inclusion. MTP was associated with favorable effects on several indicators of cancer care quality, including delivery of guideline-concordant treatment and improvements in diagnostic accuracy, staging completeness, surgical technique, and timeliness. Effects on survival and clinical trials enrollment were mixed. Delivery formats for MTP were generally not well described, and study designs were nonrandomized, limiting the ability to identify mediators of intervention effects. Continued study is warranted to clarify effective components of MTP interventions, and to understand the mechanism(s) through which MTP produces favorable effects on outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Outcomes of multidisciplinary treatment planning in US cancer care settings

Das

Baker

Altice

et al. 2018

Cancer

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“…They can influence treatment decisions [2,3] and have been associated with increased diagnosis and therapy safety, better adherence to guidelines, better documentation, higher participation rates in clinical trials, and even an improved quality of life and life expectancy of patients [1,2,4,5]. However, evidence of these beneficial effects is scarce and there has been little research into the process of decision-making at tumor boards [6,7].…”

Section: Introductionmentioning

confidence: 99%

Tumor Boards from the Perspective of Ambulant Oncological Care

Hermes-Moll¹,

Dengler

Riese³

et al. 2016

Oncol Res Treat

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Background: Cancer therapy requires the cooperation of physicians from different disciplines. At the core of the collaboration are ‘tumor boards' (also known as ‘multidisciplinary team meetings' and ‘tumor conferences'). However, there is limited health care research that addresses the multiple facets of such meetings. Material and Methods: Data were analyzed from 3 routinely conducted surveys comprising information from (i) office-based hematologists and oncologists, (ii) their patients, and (iii) quality indicators. Results: Most office-based oncologists stated that they participate in tumor boards taking place in hospitals. Although tumor boards are viewed as time intensive and lack financial compensation, they are considered as beneficial for patient care. Less than half of patients knew that their cases were discussed at a tumor board; those who knew rated the collaboration between their treating doctors as more positive, but also experienced slightly higher distress levels. The quality indicators showed that tumor board meetings were documented in three-quarters of the patient charts, but only half included the tumor board's recommendation. Conclusions: Participation in tumor boards is perceived as beneficial by oncologists and not just considered as a fulfillment of societies' recommendations or guidelines. The higher distress levels in patients who knew that their case was discussed at a tumor board may have occurred because more difficult cases are discussed at tumor boards and since the oncologists spend more time explaining the therapy process in complex cases, including the tumor board results.

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“…Each case requires a unique care plan dependent on patient, primary disease site, and metastatic burden, making treatment increasingly patient specific. Multidisciplinary case conference (MCC) review is encouraged in these complex cases as MCCs are thought to improve quality of care (2)(3)(4)(5)(6)(7)(8)(9). While many of these cases undergo MCC review, the specific benefit of MCC presentation in colorectal cancer care is currently unknown.…”

Section: Introductionmentioning

confidence: 99%

Management of colorectal cancer with synchronous liver metastases: impact of multidisciplinary case conference review

Wanis¹,

Pineda-Solís²,

Tun-Abraham³

et al. 2017

Hepatobiliary Surg. Nutr.

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Background: While no evidence exists to support mandatory multidisciplinary case conference (MCC) review for patients with synchronous colorectal cancer and liver metastases, this unique population may benefit greatly from multidisciplinary discussion. Methods:We retrospectively identified patients who underwent liver resection with curative intent for colorectal liver metastases (CRLM) at a tertiary center between January 2008 and June 2015. The characteristics of patients discussed at a weekly regional MCC were examined, and the effect of MCC review on treatment approach was assessed.Results: Sixty-six patients underwent elective surgery for synchronous colorectal cancer and liver metastases during the study period. Twenty-nine patients (44%) were presented at a MCC. Presentation was associated with greater likelihood of undergoing simultaneous or liver-first resection (P≤0.0001), with no difference in the extent of liver resection or location of primary tumor between the groups. A greater proportion of patients received chemotherapy and/or radiation following MCC discussion, without statistical significance. Conclusions:The treatment approach for patients with synchronous colorectal cancer and liver metastases may be significantly altered based on MCC review. Multidisciplinary discussion is advocated in order to facilitate equal access to individualized care.

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Tumor Board Participation Among Physicians Caring for Patients With Lung or Colorectal Cancer

Abstract: Among patients with lung or colorectal cancer, frequent physician tumor board engagement was associated with patient clinical trial participation and higher rates of curative-intent surgery for stage I to II NSCLC but not with overall survival.

Cited by 55 publications

References 22 publications

Outcomes of multidisciplinary treatment planning in US cancer care settings

Outcomes of multidisciplinary treatment planning in US cancer care settings

Tumor Boards from the Perspective of Ambulant Oncological Care

Management of colorectal cancer with synchronous liver metastases: impact of multidisciplinary case conference review

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