PPS26. Multidisciplinary tumor board documentation: assessing its frequency, quality, and impact

Tumor board (TB) meetings facilitate multidisciplinary cancer discussions and are a fundamental aspect of contemporary cancer care, yet no standards currently exist for documenting the results of TB meetings. Since lack of documentation could contribute to nonadherence to TB recommendations, this study aimed to characterize TB documentation practices at a single institution.


Methods:

A retrospective review of patients discussed at sixTBs at an NCI-designated comprehensive cancer center from 1/2024-6/2024 was conducted. The presence and quality of TB documentation in the medical record were measured. Associations with clinicodemographic variables and patient outcomes were assessed.


Results:

Among 991 patients (307 liver, 235 breast, 166 colorectal, 153 pancreas, 110 cutaneous, 20 gastroesophageal), the median age was 63 years (IQR: 51 – 71 years), most were white (84%), female (52%), and had locoregional cancer staging (66%). Overall, TB documentation was present only half the time (512 patients, 52%). Documentation varied significantly by disease site (e.g. 6% breast to 97.0% colorectal). Among patients with documentation, 45% of notes were unstructured, and their content was highly variable: 99% documented the final consensus recommendations, 58% listed what information was reviewed, 29% listed the specialty of all attendees, 11% documented the reason for discussion, and 16.0% documented if clinical trial eligibility was discussed. Only 53% of notes documented if patients were notified of the TB recommendations, most commonly via phone (69%) less often electronically (15%) or in-person (14%). At a median follow-up of 40 months, the quality of documentation was associated with patient outcomes: after excluding breast cancer patients, both TB documentation (Fig 1a) and the use of structured notes (among those with documentation, Fig 1b) were associated with improved overall survival.  


Conclusions:

Following multidisciplinary TB meetings, documentation was highly variable and may be linked to patient outcomes. Developing standards for TB documentation may improve the accurate and timely dissemination of consensus recommendations and improve the delivery of complex personalized cancer care.