Match between therapeutic proposal in multidisciplinary tumor board and actual treatment in head and neck cancer - 28/11/20

Doi : 10.1016/j.anorl.2020.11.008

J. Alkasbi ^a, G. Mortuaire ^a, B. Rysman ^a, R. Nicot ^b, D. Chevalier ^a, F. Mouawad ^a,^c,^⁎
^a Service d’ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France
^b Service de Stomatologie et de Chirurgie Maxillo-Faciale, Hôpital Roger Salengro, CHU de Lille, Université de Lille, Rue Michel Polonovski, 59037 Lille cedex, France
^c Inserm U 908, Lille Science and Technology University, UFR de Biologie - SN3, 59655 Villeneuve d’Ascq, France

^⁎Corresponding author at: Service d’ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lille, rue Michel Polonovski, 59037 Lille cedex, France.Service d’ORL et de Chirurgie Cervico-Faciale, Hôpital Huriez, CHU de Lille, Université de Lillerue Michel PolonovskiLille cedex59037France

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Saturday 28 November 2020
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Abstract

Objectives

There are few published studies evaluating the quality and outcome of multidisciplinary tumor board (MDTB) decisions. The aim of the present study was to evaluate adherence to MDTB recommendations in head and neck cancer and to document reasons in case of discordance.

Material and methods

We included all patients with newly diagnosed head and neck cancer presented in our MDTB meetings between January 1st and December 31st, 2018, whatever the tumor site, histology type and TNM classification. MDTB recommendations were compared to actual treatment. Discordance was defined as treatment partially or entirely different from the treatment decision recorded in the MDTB minutes.

Results

Board decisions were made for 344 new patients. Complete treatment concordance rate was 91.6% (315/344 patients), with deviation in 29 patients. Reasons for deviation were complications of treatment in 10 cases, patient refusal in 8, and physician's decision in 4 cases. Five patients died before therapy initiation. Mean interval from board discussion to treatment was 21 days, and depended on type of treatment (range, 1 to 74 days).

Conclusion

This study shows the importance of evaluating concordance between the protocol proposed in the MDTB and the treatment actually received, to identify factors for deviation and remedy them when possible.

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Keywords : Multi-disciplinary tumor board, Head and neck cancer, Adherence to treatment recommendation, Deviation