Multidisciplinary tumor boards in pediatric surgical oncology: a systematic review of approaches in low- and middle-income countries

Abstract

Pediatric cancer outcomes have improved significantly in recent decades, importantly through multidisciplinary collaboration. Multidisciplinary Tumor Boards (MTBs) foster cross-specialty discussions, leading to refined treatment plans. However, their use in low- and middle-income countries (LMICs) remains underexplored. This systematic review aims to assess existing literature on pediatric MTBs in LMICs to elucidate their current status and identify strategies that enhance their adoption and impact patient outcomes. Following PRISMA guidelines, we searched PubMed, Google Scholar, and SciELO for quantitative and qualitative studies on pediatric MTBs in LMICs. Interventional and observational studies were included, while adult-only research, those set in high-income countries, or lacking results were excluded. Eight out of 2699 studies met inclusion criteria. Risk of bias was assessed using the Newcastle-Ottawa Scale. Collectively, 1063 pediatric patient cases were evaluated, with 90-min MTBs being most common. Attendees included pediatric oncologists, pediatric surgeons, radiologists, radiation oncologists, and pathologists. MTBs improved patient care and standardized treatment. However, LMICs faced challenges such as limited resources, lack of protected time, and unreliable internet access. Despite these barriers, MTBs remain vital for advancing pediatric cancer care in LMICs. Strengthening institutional support and policy frameworks is essential to sustaining and scaling MTBs, ultimately improving cancer care and outcomes for children in resource-constrained settings.

Keywords: Low- and middle-income countries; Multidisciplinary tumor board; Pediatric oncology; Pediatric solid tumors; Pediatric surgical oncology.