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Observational Study
. 2017 Feb;19(2):133-139.
doi: 10.1016/j.hpb.2016.11.002. Epub 2016 Dec 1.

Utility of a multidisciplinary tumor board in the management of pancreatic and upper gastrointestinal diseases: an observational study

David G Brauer  1 , Matthew S Strand  1 , Dominic E Sanford  1 , Vladimir M Kushnir  2 , Kian-Huat Lim  2 , Daniel K Mullady  2 , Benjamin R Tan Jr  2 , Andrea Wang-Gillam  2 , Ashley E Morton  2 , Marianna B Ruzinova  3 , Parag J Parikh  4 , Vamsi R Narra  5 , Kathryn J Fowler  5 , Majella B Doyle  1 , William C Chapman  1 , Steven S Strasberg  1 , William G Hawkins  1 , Ryan C Fields  6
Affiliations
Observational Study

Utility of a multidisciplinary tumor board in the management of pancreatic and upper gastrointestinal diseases: an observational study

David G Brauer et al. HPB (Oxford). 2017 Feb.

Abstract

Background & objectives: Multidisciplinary tumor boards (MDTBs) are frequently employed in cancer centers but their value has been debated. We reviewed the decision-making process and resource utilization of our MDTB to assess its utility in the management of pancreatic and upper gastrointestinal tract conditions.

Methods: A prospectively-collected database was reviewed over a 12-month period. The primary outcome was change in management plan as a result of case discussion. Secondary outcomes included resources required to hold MDTB, survival, and adherence to treatment guidelines.

Results: Four hundred seventy cases were reviewed. MDTB resulted in a change in the proposed plan of management in 101 of 402 evaluable cases (25.1%). New plans favored obtaining additional diagnostic workup. No recorded variables were associated with a change in plan. For newly-diagnosed cases of pancreatic ductal adenocarcinoma (n = 33), survival time was not impacted by MDTB (p = .154) and adherence to National Comprehensive Cancer Network guidelines was 100%. The estimated cost of physician time per case reviewed was $190.

Conclusions: Our MDTB influences treatment decisions in a sizeable number of cases with excellent adherence to national guidelines. However, this requires significant time expenditure and may not impact outcomes. Regular assessments of the effectiveness of MDTBs should be undertaken.

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Conflict of interest statement

Disclosures: All authors report no conflicts of interest or financial disclosures relevant to this work.

Figures

Figure 1
Figure 1
Distribution of pre-conference plans (left) and post-conference plans (right) for all cases reviewed at MDTB
Figure 2
Figure 2
Distribution of pre-conference plans and post-conference plans for cases experiencing a change in plan as a result of presentation at MDTB (n = 101). Post-conference plans favored obtaining additional information including imaging and diagnostic procedures
See this image and copyright information in PMC

References

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