Oncologist Participation in Tumor Board Meetings May Be Associated With Improved Outcomes for Patients With Lung or Colorectal Cancers
A new population-based study of close to 5,000 patients and 1,600 oncologists found that physician participation in weekly tumor board meetings was associated with improved survival for patients with stage IV colorectal cancer and stage IV/extensive-stage small cell lung cancer, but not other cancer subtypes and stages. The findings were presented at the 2014 ASCO Quality Care Symposium (Abstract 179).
Patients whose physicians participate in tumor board meetings weekly also were more likely to enroll in clinical trials compared to patients whose physicians who participate less often in such meetings, and patients with early-stage non–small cell lung cancer were more likely to receive curative surgery. While these findings are still exploratory, they underscore the important function of tumor board meetings and provide important groundwork for future research.
Tumor boards generally serve to allow physicians (surgoens, medical oncologists, and radiation oncologists) and other health-care professions to discuss difficult cases and facilitate treatment planning for individual patients. Occasionally, tumor board meetings may serve only as teaching sessions for attendees. Although tumor boards are common, until this study, there had been little research on how tumor boards are structured in various health-care delivery settings.
Study Details
Researchers surveyed 4,620 patients with lung or colorectal cancer and their physicians. The 1,601 physicians who participated in the study practiced in a variety of health system settings, ranging from single-physician practices to group practices, as well as both community and academic hospitals. In the survey, physicians were asked if and how often they participated in tumor boards, and about the purpose and scope of those meetings. Patients were asked about communication among their health-care providers. Patient medical records were reviewed to assess associations between tumor boards and patient clinical trial enrollment, receipt of curative treatment, patient-reported quality of care, and survival.
Overall, tumor board participation was high: 96% of cancer care providers routinely participated in some kind of tumor board meeting, and 54% did so weekly. Most (82%) tumor board meetings served a pretreatment planning function, and only 12% served as a teaching session. The great majority (87%) of tumor board meetings overall reviewed a variety of cancer types, but more than half (59%) reviewed only challenging cases.
Study Findings
The study identified several associations between patient outcomes and tumor board features and meeting frequency. Patients with extensive-stage small cell lung cancer and stage IV colorectal cancer had better survival if their physicians participated in tumor boards at least weekly, as opposed to less often. Conversely, patients with small cell lung cancer whose physicians’ tumor boards served only as teaching functions had slightly worse survival.
Adjusted for other physician and patient characteristics, patients whose physicians participated in tumor boards weekly had an estimated 60% higher odds of enrolling in a clinical trial than patients whose doctors participated less often or never. This suggests that identifying clinical trials for patients may be an important function of tumor board meetings.
Physician tumor board participation was also associated with receipt of guideline-compliant care. Patients with stage I or stage II non–small cell lung cancer were more likely to receive curative-intent surgery if their physicians participated in tumor boards weekly and if those tumor boards included evaluation of prior treatment decisions, but they were less likely to have the surgery if their physicians’ tumor boards reviewed a variety of cancer sites.
“Patients with disease subtypes for which we found a link between physician tumor board participation and improved outcomes may want to ask their doctor if their case will be reviewed at a multidisciplinary meeting,” said lead study author Kenneth L. Kehl, MD, a fellow in cancer medicine, at The University of Texas MD Anderson Cancer Center in Houston. “However, as this was not a randomized study and there were few associations overall between tumor boards and patient survival, our findings cannot demonstrate conclusively that physician tumor board participation directly affects patient outcomes.”
The study authors reported no potential conflicts of interest.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
