Physician Compliance with Multidisciplinary Tumor Board Recommendations for Managing Gynecological Cancers

Abstract

Aims: Evaluation of compliance with gynecological multidisciplinary tumor board (MTB) recommendations and its impact. Patients & methods: All patient records discussed in our MTB from 2018 to 2020 were analyzed. Results: We analyzed 437 MTB recommendations concerning 166 patients. Each patient was discussed an average of 2.6 (1.0–4.2) times. Of the 789 decisions, the decision was not followed 102 times (12.9%), corresponding to 85 MTB meetings (19.5%). Of these, 72 recommendations concerned therapeutic changes (70.5%), and 30 concerned non-therapeutic changes (29.5%). Of these 85 MTB decisions, 60 (71%) led to a new MTB submission. Noncompliance with MTB decisions decreased the overall survival (46 vs 138 months; p = 0.003). Conclusion: Improving compliance with MTB decisions is crucial to enhance patient outcomes.

Plain language summary

In multidisciplinary tumor board (MTB) meetings, a team of experts discuss the diagnosis and management of cancer patients. While MTB treatment decisions and the reasoning behind them are well documented, the application of these decisions in practice and the associated impact on survival are unknown. This study evaluated compliance with recommendations made during gynecological weekly MTB meetings and the resulting impact on patient management. Between 2018 and 2020, 166 patients were discussed in 437 MTB meetings (each patient was discussed an average of 2.6 times during this period). Noncompliance with the MTB recommendations affected 85/437 MTB meetings (19.5%). Of these, 57 recommendations were therapeutic changes (67.1%) and 28 were non-therapeutic changes (32.9%). In 60 cases (71%), noncompliance with the MTB led to resubmission of the patient data to the MTB. Noncompliance with the board recommendations led to a decrease in patient survival (46 vs 138 months; p = 0.003). This study is expected to raise awareness among practitioners. Considered an essential part of the delivery of high-quality cancer treatment, the implementation of MTB decisions requires further verification.

Tweetable abstract

Considered an essential component in the delivery of high-quality oncology treatment, the implementation of multidisciplinary tumor board decisions requires verification.

Keywords::

• compliance
• gynecological cancers
• multidisciplinary tumor boards

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/fon-2023-1183

Author contributions

Conceptualization: E Deluche; methodology: E Deluche, S Leobon; formal analysis: C Naessens; writing – original draft preparation: E Deluche, C Naessens; writing – review and editing: C Naessens, J Laloze, S Leobon, T Gauthier, A Lacorre, J Monteil, L Venat, E Deluche; validation: C Naessens, J Laloze, S Leobon, T Gauthier, A Lacorre, J Monteil, L Venat, E Deluche; supervision: E Deluche. All authors have read and agreed to the published version of the manuscript.

Acknowledgments

The authors thank Textcheck for assistance with English-language editing. The English in this document has been checked by at least two professional editors, both native speakers of English.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.