A new population-based study of close to 5,000 patients and 1,600 oncologists found that physician participation in weekly tumour 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.

Additionally, patients whose physicians participate in tumour board meetings weekly were more likely to enrol 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 tumour board meetings and provide important groundwork for future research.

Tumour boards are meetings among physicians (surgeons, medical oncologists, and radiation oncologists) and other healthcare professionals who provide cancer care.

They generally serve to discuss difficult cases and facilitate treatment planning for individual patients.

Occasionally, tumour board meetings may serve only as teaching sessions for attendees.

Although tumour boards are common, until this study, there had been little research on how tumour boards are structured in various healthcare delivery settings.

“Patients with disease subtypes for which we found a link between physician tumour 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 M. D. Anderson Cancer Center in Houston.

“However, as this was not a randomised study and there were few associations overall between tumour boards and patient survival, our findings cannot demonstrate conclusively that physician tumour board participation directly affects patient outcomes.”

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 tumour boards, and about the purpose and scope of those meetings. Patients were asked about communication among their healthcare providers.  Patient medical records were reviewed to assess associations between tumour boards and patient clinical trial enrolment, receipt of curative treatment, patient-reported quality of care, and survival.

Overall, tumour board participation was high ─ 96 percent of cancer care providers routinely participated in some kind of tumour board meeting, and 54 percent did so weekly.

Most (82 percent) of tumour board meetings served a pre-treatment planning function, and only 12 percent served as a teaching session.

The great majority (87 percent) of tumour board meetings overall reviewed a variety of cancer types, but more than half (59 percent) reviewed only challenging cases.

The study identified several associations between patient outcomes and tumour 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 tumour boards at least weekly, as opposed to less often.

Conversely, patients with small cell lung cancer whose physicians’ tumour boards served only as teaching functions had slightly worse survival.

Adjusted for other physician and patient characteristics, patients whose physicians participated in tumour boards weekly had an estimated 60 percent 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 tumour board meetings.

Physician tumour 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 tumour boards weekly, and if those tumour boards included evaluation of prior treatment decisions, but they were less likely to have the surgery if their physicians’ tumour boards reviewed a variety of cancer sites.

Source: ASCO