Establishing a national multidisciplinary board for complex pediatric renal tumors: Lessons learned

Area of Science:

• Pediatric Oncology
• Cancer Research
• Clinical Collaboration

Background:

• The UMBRELLA 2016-SIOP RTSG protocol highlights challenges in bilateral Wilms tumor management.
• It recommends national multidisciplinary Wilms tumor boards (MWTB) for complex cases.

Purpose of the Study:

• To establish and evaluate a national MWTB for complex pediatric cancer cases, including bilateral Wilms tumor.
• To assess the impact of MWTB recommendations on treatment strategies and patient outcomes.

Main Methods:

• A national MWTB was created for monthly, web-based case discussions.
• Participants included radiation oncologists, surgeons, pediatric oncologists, radiotherapists, and pathologists.
• Patients from all centers within the Société Française des Cancers de l'Enfant (SFCE) were reviewed.

Main Results:

• 251 cases involving 171 patients were discussed between January 2018 and December 2023.
• Referral reasons included bilateral disease (50.4%), metastatic cases (22.5%), and other complex presentations (19.8%).
• MWTB recommendations led to treatment modifications in two-thirds of cases, particularly regarding surgical approach and timing.

Conclusions:

• The MWTB demonstrates successful national multidisciplinary collaboration for complex pediatric cancer cases.
• This initiative aligns with recommendations to improve care quality and extends beyond the UMBRELLA protocol's scope.
• High participant satisfaction indicates the MWTB's value in guiding individualized treatment strategies.