Guideline adherence and implementation of tumor board therapy recommendations for patients with gastrointestinal cancer
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Published:2022-04-08
Issue:3
Volume:149
Page:1231-1240
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ISSN:0171-5216
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Container-title:Journal of Cancer Research and Clinical Oncology
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language:en
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Short-container-title:J Cancer Res Clin Oncol
Author:
Krause Alina, Stocker Gertraud, Gockel Ines, Seehofer Daniel, Hoffmeister Albrecht, Bläker Hendrik, Denecke Timm, Kluge Regine, Lordick Florian, Knödler MarenORCID
Abstract
Abstract
Purpose
Although participation in multidisciplinary tumor boards (MTBs) is an obligatory quality criterion for certification, there is scarce evidence, whether MTB recommendations are consistent with consensus guidelines and whether they are followed in clinical practice. Reasons of guideline and tumor board deviations are poorly understood so far.
Methods
MTB’s recommendations from the weekly MTB for gastrointestinal cancers at the University Cancer Center Leipzig/Germany (UCCL) in 2020 were analyzed for their adherence to therapy recommendations as stated in National German guidelines and implementation within an observation period of 3 months. To assess adherence, an objective classification system was developed assigning a degree of guideline and tumor board adherence to each MTB case. For cases with deviations, underlying causes and influencing factors were investigated and categorized.
Results
76% of MTBs were fully adherent to guidelines, with 16% showing deviations, mainly due to study inclusions and patient comorbidities. Guideline adherence in 8% of case discussions could not be determined, especially because there was no underlying guideline recommendation for the specific topic. Full implementation of the MTBs treatment recommendation occurred in 64% of all cases, while 21% showed deviations with primarily reasons of comorbidities and differing patient wishes. Significantly lower guideline and tumor board adherences were demonstrated in patients with reduced performance status (ECOG-PS ≥ 2) and for palliative intended therapy (p = 0.002/0.007).
Conclusions
The assessment of guideline deviations and adherence to MTB decisions by a systematic and objective quality assessment tool could become a meaningful quality criterion for cancer centers in Germany.
Funder
Universitätsklinikum Leipzig
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Oncology,General Medicine
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