Abstract
138 Background: Optimal cancer care is achievable when input is available from specialists in all related disciplines. To exploit the breadth and depth of clinical expertise within a large healthcare network, regularly scheduled web-based multidisciplinary tumor boards related to complex GI and breast cancers have been established. Methods: Monthly national and quarterly international multispecialty tumor boards were held in 2014. Each center presented a case for discussion and suggested management on a predetermined solid tumor subtype or clinical scenario. A web-based interface was used to show key information to the group in real time, including imaging, pathology, and laboratory results. Subspecialty participation included well known centers of excellence in radiation oncology, medical oncology, clinical research, surgical oncology and interventional oncology. A process to assure HIPPA compliance was implemented, and CME awarded. Results: Sarah Cannon centers in Nashville, Kansas City, Denver, San Antonio, Austin and London participated. An average attendance of ten physicians per center (range 4-18) was seen. Survey results demonstrated significant value as reported by participants in improving patient care leading to the development of a prospective clinical trial in one instance. Therapeutic options not available in the US but offered in the London center were discussed and a mechanism for direct referral to the London facility was developed. Improved rates of breast conservation (18% increase), breast reconstruction (31% increase) and use of AJCC staging (24% increase) were the product of breast conferences in each market. Conclusions: Physicians overwhelmingly supported and valued multidisciplinary tumor boards for GI and breast cancers. Consensus development, sharing of best practices, and promotion of the latest evidence based management led to changes in patient care. Additional centers will be invited to join meetings this year, with planned expansion to initiate similar meetings in blood and thoracic malignancies.
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