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Effect of Multidisciplinary Cancer Conference on Treatment Plan for Patients With Primary Rectal Cancer
Ryan C Snelgrove1, Jhananiee Subendran, Kartik Jhaveri
11 Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada 2 Zane Cohen Centre for Digestive Diseases, Toronto, Ontario, Canada 3 Joint Department of Medical Imaging, Mount Sinai Hospital, University Health Network, Women's College, Toronto, Ontario, Canada 4 Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada 5 Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada 6 Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada 7 Institute of the Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Background:
Although multidisciplinary cancer conferences have been reported to lead to improved patient outcomes, few studies have reported results of these for rectal cancer.
Objective:
The purpose of this work was to assess the quality of multidisciplinary cancer conferences, the effect of the conference on the initial treatment plan, compliance with the conference treatment recommendations, and clinical outcomes for rectal cancer.
Design:
This was a prospective, longitudinal study.
Settings:
The study was conducted at a tertiary care academic hospital.
Patients:
Patients with primary rectal cancer were included in this study.
Intervention:
The intervention was a rectal cancer-specific multidisciplinary cancer conference.
Main Outcome Measures:
The quality of the multidisciplinary cancer conference was assessed using the Cancer Care Ontario Multidisciplinary Cancer Conference standards score. A change in treatment plan was defined as a change from the initial treatment plan selected by the treating physician to an alternate treatment plan recommended at the conference.
Results:
Twenty-five multidisciplinary cancer conferences were conducted over a 10-month study period. The Cancer Care Ontario Multidisciplinary Cancer Conference standards score was 7 (from a maximum score of 9). Forty-two patients with primary rectal cancer were presented, and there was a 29% (12/42) change in the initial treatment plan. A total of 42% (5/12) of these changes were attributed to reinterpretation of the MRI findings. There was 100% compliance with the conference treatment recommendations. The circumferential resection margin was positive in 5.5% (2/36).
Limitations:
Selection bias may have led to an overestimate of effect, and there is no control group for comparison of clinical outcomes.
Conclusions:
A high-quality rectal cancer-specific multidisciplinary cancer conference led to a 29% change in the treatment plan for patients with primary rectal cancer, with almost half of these changes attributed to reinterpretation of the magnetic resonance images.
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