Evaluating the impact of the genitourinary multidisciplinary tumour board: Should every cancer patient be discussed as standard of care?

  • Kyle Scarberry University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine
  • Lee Ponsky University Hospitals Cleveland Medical Center
  • Edward Cherullo University Hospitals Cleveland Medical Center
  • William Larchian University Hospitals Cleveland Medical Center
  • Donald Bodner University Hospitals Cleveland Medical Center
  • Matthew Cooney University Hospitals Cleveland Medical Center
  • Rodney Ellis University Hospitals Cleveland Medical Center
  • Gregory MacLennan University Hospitals Cleveland Medical Center
  • Ben Johnson University Hospitals Cleveland Medical Center
  • William Tabayoyong University Hospitals Cleveland Medical Center
  • Robert Abouassaly University Hospitals Cleveland Medical Center

Abstract

Introduction: We sought to prospectively evaluate the effectiveness of the multidisciplinary tumour board (MTB) on altering treatment plans for genitourinary (GU) cancer patients.

Methods: All GU cancer patients seen at our tertiary care hospital are discussed at MTB. We prospectively collected data on adult patients discussed over a continuous, 20-month period. Physicians completed a survey prior to MTB to document their opinion on the likelihood of change in their patient’s treatment plan. Logistic regression was used to asses for factors associated with a change by the MTB, including patient age or sex, malignancy type, the predicted treatment plan, and the provider’s years of experience or fellowship training.

Results: A total of 321 cancer patients were included. Patients were primarily male (84.4%) with a median age of 67 years old (range 20–92). Prostate (38.9%), bladder (31.8%), and kidney cancer (19.6%) were the most common malignancies discussed. A change in management plan following MTB was observed in 57 (17.8%) patients. The physician predicted a likely change in six (10.5%) of these patients. Multivariate logistic regression did not determine physician prediction to be associated with treatment plan change, and the only significant variable identified was a plan to discuss multiple treatment options with a patient (odds ratio 2.46; 95% confidence interval 1.09–9.54).

Conclusions: Routine discussion of all urologic oncology cases at MTB led to a change in treatment plan in 17.8% of patients. Physicians cannot reliably predict which patients have their treatment plan altered. Selectively choosing patients to be presented likely undervalues the impact of a multidisciplinary approach to care.

Published
2018-05-14
How to Cite
Scarberry, K., Ponsky, L., Cherullo, E., Larchian, W., Bodner, D., Cooney, M., Ellis, R., MacLennan, G., Johnson, B., Tabayoyong, W., & Abouassaly, R. (2018). Evaluating the impact of the genitourinary multidisciplinary tumour board: Should every cancer patient be discussed as standard of care?. Canadian Urological Association Journal, 12(9), E403-8. https://doi.org/10.5489/cuaj.5150
Section
Original Research