Asco Survey: Use and Efficiency of Multidisciplinary Tumor Boards Worldwide

Abstract

ABSTRACT Aim: Although Multidisciplinary Tumor Boards (MDTBs) are universally recommended, a recent survey from the USA did not find a significant effect on patient outcome at Veterans Administration Hospitals. We aimed at evaluating the use and benefit of MDTB worldwide. Methods: We conducted an ASCO survey of a randomly selected cohort of 5357 ASCO International members in October-November 2013. Survey was approved by ASCO International Affairs Committee and built on SurveyMonkey website. Results: 501 ASCO members practicing outside of the USA responded. The majority (86%) participates in MDTB at their own institutions. Majority held weekly specialty and/or General MDTBs. 89% of 409 respondents attended to seek advice to make treatment decisions. 1-25% change in type of surgery or treatment plan occurs in 44-49% of breast cancer cases. 25-50% change in surgery was reported in 14-21% of cases. 1-25% change occur in 47-50% of colorectal cancer cases, with 25-50% change in surgery type/treatment plans reported in 12-18% of colorectal cancer cases. Multinomial regression showed that non-medical oncologists were 2.5 times more likely than medical oncologists to have a change in treatment plans of more than 50% in breast tumor boards (p-value = 0.03). Also, physicians who have been practicing for less than 15 years were 1.21 and 1.75 times more likely in breast and GI tumor boards. Vast majority said MDTB helps them make management decisions. 96% of 430 respondents said that the overall benefit to the patient is worth the time and effort spent of tumor boards. 96% said tumor boards have a significant teaching value. Suggestions to improve efficiency included a more effective moderator, better time management, criteria for selecting cases, and written pre-meeting summaries. Mini-Tumor Boards held with available specialists were favored. 425 of 448 said MDTBs should be required where cancer patients are treated. Conclusions: ASCO International Survey shows that tumor boards are commonplace and useful multidisciplinary forums for patient management worldwide and worth the time spent. Change of treatment occurs more frequently when breast cancer cases are presented by non-medical oncologists. Mini-tumor boards may improve time efficiency and are favored when full-team is not available. Suggestions for more efficiency are discussed. Disclosure: All authors have declared no conflicts of interest.