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Annals of Surgical Oncology

, Volume 22, Issue 5, pp 1533–1539 | Cite as

Multidisciplinary Cancer Conferences for Gastrointestinal Malignancies Result in Measureable Treatment Changes: A Prospective Study of 149 Consecutive Patients

  • Jacqueline Oxenberg
  • Wesley Papenfuss
  • Iyare Esemuede
  • Kristopher Attwood
  • Marko Simunovic
  • Boris Kuvshinoff
  • Valerie Francescutti
Gastrointestinal Oncology

Abstract

Background

In most jurisdictions, a minority of patients are discussed at multidisciplinary cancer conference (MCC) despite recommendations for such reviews. We assessed the impact of MCC review of gastrointestinal (GI) cancers at a stand-alone cancer center.

Methods

Patient data were prospectively collected on consecutive cases presented at a GI MCC during a 6-month period. Original treatment plans were collected confidentially before presentation and compared to post-MCC treatment plans. We defined changes in management plans as major (change in treatment modality) or minor (testing prior to original plan).

Results

A total of 149 cases were evaluated: 115 upper GI (gastric/small bowel—10 %, liver—32 %, pancreaticobiliary—36 %), and 34 lower GI (23 %). Reasons for presentation were: questions regarding progression/metastases (44 %), management (26 %), diagnosis (21 %), pathology (15 %), and resectability (7 %). Physicians were certain of their original plans being the final recommendations in 84 % (n = 125). Change in management was recommended in 36 %; 72 % were major and 28 % were minor. Patients underwent all recommended treatments at our institution in 77 % of cases, a portion in 5 %, and no recommended treatments in 18 %. On multivariate analysis, physician degree of certainty for original management plan was not predictive of a change in management plan (p = 0.61).

Conclusions

Although certainty of prediscussion treatment plan is high, changes in treatment recommendations occurred in more than one-third of patients after GI MCC. This prospective study demonstrates the value of MCC in GI cancer sites, even at a stand-alone cancer center.

Keywords

Disease Site Original Plan Roswell Park Cancer Institute Liver Case Liver Directed Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Jacqueline Oxenberg
    • 1
  • Wesley Papenfuss
    • 1
  • Iyare Esemuede
    • 1
  • Kristopher Attwood
    • 2
  • Marko Simunovic
    • 3
  • Boris Kuvshinoff
    • 1
  • Valerie Francescutti
    • 1
  1. 1.Department of Surgical OncologyRoswell Park Cancer InstituteBuffaloUSA
  2. 2.Department of BiostatisticsRoswell Park Cancer InstituteBuffaloUSA
  3. 3.Department of SurgeryMcMaster UniversityHamiltonCanada

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