A Prospective Observational Study on the Structuring Process and Implementation of a Large Regional, Inter-hospital, Virtual Multidisciplinary Tumor Board on Prostate Cancer.

Prostate cancer adherence to guidelines multidisciplinary tumor boards virtualization

Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Jan 2023
Historique:
received: 28 10 2022
revised: 02 11 2022
accepted: 03 11 2022
entrez: 30 12 2022
pubmed: 31 12 2022
medline: 4 1 2023
Statut: ppublish

Résumé

At present, multidisciplinary tumor boards (MDTB) are considered best practice in oncology. However, web-based virtualization of MDTB may increase participation in meetings, the number of cases discussed, and adherence to guidelines, deliver better treatment, and eventually improve outcomes for patients with prostate cancer. This is an observational study focused on exploring the structuring process and implementing a multi-institutional virtual MDTB in Sicily, Italy. Other endpoints included the analysis of cooperation between participants, adherence to guidelines, patient outcomes, and patient satisfaction. Overall, 126 patients were referred to the virtual MDTB for a total of 302 cases discussed in an 18-month period. Nearly 45% of cases were referred from general hospitals or tertiary centers, 38% from comprehensive cancer centers, and only 17% from academic ones. Most health professional participants (95%) reported eliminating geographical barriers and consequently reducing costs and saving time as key advantages of virtual meetings over face-to-face ones. Using a specifically designed platform for virtual MDTBs was another excellent point, especially to geolocate clinical trials and time-lapse data storage. The majority of referred patients had stage T 3-4 prostate cancer (79%). Overall, 71% of proposals discussed were approved unchanged, while 19% changed after the virtual MDTB discussion. Debated points were mostly radiologic, surgical, medical, or radiation treatment-related issues. In particular, the prescriptive appropriateness of positron emission tomography with 68Ga-prostatic specific membrane antigen, newer drugs, radiation versus surgical approach, stage T3-4 cases, and adjuvant therapy represented the most debated issues. The proposed diagnostic and/or therapeutic options were controlled for adherence to the guidelines and/or updated scientific evidence. Overall, 98% of approved proposals and changes were in line with the guidelines. Overall, most participants felt virtual MDTB was very useful and case discussions led to a major change of strategy in 19% of cases. Virtual MDTBs are a very useful way to achieve best management of prostate cancer while saving time and fostering cooperation.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
At present, multidisciplinary tumor boards (MDTB) are considered best practice in oncology. However, web-based virtualization of MDTB may increase participation in meetings, the number of cases discussed, and adherence to guidelines, deliver better treatment, and eventually improve outcomes for patients with prostate cancer.
PATIENTS AND METHODS METHODS
This is an observational study focused on exploring the structuring process and implementing a multi-institutional virtual MDTB in Sicily, Italy. Other endpoints included the analysis of cooperation between participants, adherence to guidelines, patient outcomes, and patient satisfaction.
RESULTS RESULTS
Overall, 126 patients were referred to the virtual MDTB for a total of 302 cases discussed in an 18-month period. Nearly 45% of cases were referred from general hospitals or tertiary centers, 38% from comprehensive cancer centers, and only 17% from academic ones. Most health professional participants (95%) reported eliminating geographical barriers and consequently reducing costs and saving time as key advantages of virtual meetings over face-to-face ones. Using a specifically designed platform for virtual MDTBs was another excellent point, especially to geolocate clinical trials and time-lapse data storage. The majority of referred patients had stage T 3-4 prostate cancer (79%). Overall, 71% of proposals discussed were approved unchanged, while 19% changed after the virtual MDTB discussion. Debated points were mostly radiologic, surgical, medical, or radiation treatment-related issues. In particular, the prescriptive appropriateness of positron emission tomography with 68Ga-prostatic specific membrane antigen, newer drugs, radiation versus surgical approach, stage T3-4 cases, and adjuvant therapy represented the most debated issues. The proposed diagnostic and/or therapeutic options were controlled for adherence to the guidelines and/or updated scientific evidence. Overall, 98% of approved proposals and changes were in line with the guidelines. Overall, most participants felt virtual MDTB was very useful and case discussions led to a major change of strategy in 19% of cases.
CONCLUSION CONCLUSIONS
Virtual MDTBs are a very useful way to achieve best management of prostate cancer while saving time and fostering cooperation.

Identifiants

pubmed: 36585190
pii: 43/1/501
doi: 10.21873/anticanres.16187
doi:

Types de publication

Observational Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

501-508

Informations de copyright

Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Maria Rosaria Valerio (MR)

Medical Oncology Unit, Policlinico P. Giaccone, University of Palermo, Palermo, Italy.

Vincenzo Serretta (V)

Urology Unit, La Maddalena Clinic for Cancer, former University of Palermo, Palermo, Italy.

Demetrio Arico (D)

Nuclear Medicine Service, Istituto Clinico Humanitas, Catania, Italy.

Ivan Fazio (I)

Radiotherapy Unit, Clinica Macchiarella, Palermo, Italy.

Vincenzo Altieri (V)

Urology Unit, University Federico II, Naples, Italy.

Sergio Baldari (S)

Nuclear Medicine Service, Policlinico Barresi, Università di Messina, Messina, Italy.

Michele Pennisi (M)

Urology Unit, Ospedale Cannizzaro, Catania, Italy.

Andrea Girlando (A)

Radiation Therapy Unit, Istituto Clinico Humanitas, Catania, Italy.

Massimiliano Spada (M)

Medical Oncology Unit, Fondazione Giglio, Cefalù, Italy.

Cristina Scalisi Gesolfo (CS)

Urology Unit, Ospedale Villa Sofia, Palermo, Italy.

Marco Messina (M)

Medical Oncology Unit, ARNAS, Palermo, Italy.

Carlo Messina (C)

Medical Oncology Unit, ARNAS, Palermo, Italy.

Leone Giorgia (L)

Pathology Unit, Istituto Clinico Humanitas, Catania, Italy.

Giovanni Sortino (G)

Medical Oncology Unit, Fondazione Giglio, Cefalù, Italy.

Alfio DI Grazia (A)

Radiation Therapy Unit, Istituto Clinico Humanitas, Catania, Italy.

Rossella Guggino (R)

Clinical Nutrition Service, ASP, Palermo, Italy.

Nicolo Borsellino (N)

Medical Oncology Unit, Ospedale Fatebenefratelli, Palermo, Italy.

Dario Piazza (D)

Medical Oncology Unit, La Maddalena Clinic for Cancer, Palermo, Italy.

Vittorio Gebbia (V)

Medical Oncology Unit, La Maddalena Clinic for Cancer, Palermo, Italy; vittorio.gebbia@gmail.com.
Oncology Section, Biomedical Department of Internal and Specialized Medicine, University of Palermo, Palermo, Italy.

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Classifications MeSH