Impact of multidisciplinary tumor boards on clinical decision making in a genitourinary oncology clinic in Mexico city.

person Alec Seidman Sorsby Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Insurgentes Mixcoac, Mexico info_outline Alec Seidman Sorsby, Rosa Caballero, Fernanda Estefanía Rivera, Yuly Andrea Remolina Bonilla, Karina G. Vazquez-Narváez, Sara E. Vazquez-Manjarrez, Christian Haydeé Flores Balcázar, Ricardo A. Castillejos-Molina, Francisco Rodriguez-Covarrubias, Maria T. Bourlon

Authors person Alec Seidman Sorsby Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Insurgentes Mixcoac, Mexico info_outline Alec Seidman Sorsby, Rosa Caballero, Fernanda Estefanía Rivera, Yuly Andrea Remolina Bonilla, Karina G. Vazquez-Narváez, Sara E. Vazquez-Manjarrez, Christian Haydeé Flores Balcázar, Ricardo A. Castillejos-Molina, Francisco Rodriguez-Covarrubias, Maria T. Bourlon Organizations Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Insurgentes Mixcoac, Mexico, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, DF, Mexico, Salvador Zubirán National Institute of Health Sciences and Nutrition, Mexico, DF, Mexico, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico Ctiy, Mexico, Urologic Oncology Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, DF, Mexico Abstract Disclosures Research Funding No funding sources reported Background: Effective management of genitourinary neoplasms demands a comprehensive approach due to the diverse treatment options and the need for multiple specialists. Multidisciplinary tumor board (MDTB) meetings are a platform for experts to collectively assess and discuss the latest evidence and provide their expertise to tailor treatment plans for patients. Methods: Cases discussed during uro-oncology MDTB meetings at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán in Mexico City over a five-year period (01/2018 to 12/2022) were included. We analyzed the type of neoplasm, reason for case discussion, specialties involved and whether the final decision led to a modification of the original plan. Descriptive statistics were used for analysis. Chi-squared test was used to determinate differences and p value < 0.05 was considered statistically significant. A logistic regression analysis was performed for multivariate analysis. Results: Over the study period, 500 discussions involving 399 patients were included. 87% were men. Prostate, kidney, testicular, upper tract urothelial and bladder carcinoma, represented: 223 (44.6%), 117 (23.4%), 84 (16.8%), 37 (7.4%), 32 (6.4%) of cases, respectively. The majority were presented by urology (319 cases; 63.6%). The primary reason for presentation was surgical decisions in 54.6%. Regarding final conclusions, 55.8% underwent modifications in the treatment plan, 33.2% had no changes and 11% remained inconclusive, requiring further assessment. Individuals with metastatic disease had a higher likelihood of treatment plan changes in 61.6% vs 52.3% (OR 1.46 95%CI 1.01-2.12; p = 0.042). The 163 cases (32.6%) presented during the COVID-19 pandemic were more prone to have treatment modifications 62.6% vs 52.5% (OR 1.51 95%CI 1.03-2.22; p = 0.034); cases presented for surgical reasons during this period were more likely to have a change in treatment modality 74% vs 52.3% (OR 2.6 95%CI 1.34-5.04; p = 0.004). Implementation of results was successful in most cases (72%), with a median time of 3.6 weeks. Reasons for not implementing the plan included: patient decision, treating physician decision, comorbidities, death, and lack of resources. Factors associated with implementation in the multivariate analysis included: male gender (OR 2.81), cases presented during pandemic (OR 2.0), and by urology service (OR 1.92). Conclusions: Among patients presented in our uro-oncology MDTB meetings, more than half will have a change in the original treatment plan, and this agreed strategy is successfully implemented in most individuals. These sessions remained key for patient management during the COVID-19 pandemic.