E231: Analysis of Pancreas Multidisciplinary Tumor Board: Do Presented Patients Receive More Appropriate Care?

Introduction: Cancer is a complex disease process requiring diagnostic testing and treatment from multiple separate disciplines. Having access to multidisciplinary team-based care has been shown to increase proportions of patients undergoing appropriate diagnostic work up. The diagnostic and management algorithms for pancreatic cancer (as per the National Comprehensive Cancer Network Guidelines) are particularly complicated and have a major impact on overall patient outcome. The current analysis aims to determine whether presentation at a multidisciplinary tumor board (MDT) is associated with more appropriate diagnostic work up and treatment.

Methods: A retrospective review of pancreatectomy patients receiving care at a tertiary referral center was performed between 2019-2022 using operating room records and MDT presentation lists maintained by the Division of Surgical Oncology. Demographic, diagnostic work up, and treatment data were compared between patients who were and were not presented at MDT.

Results: A total of 190 patients were included in the study. 166 patients (87.4%) had their cases presented at MDT while 24 (12.6%) were not presented at MDT. Mean age was 63.3 years and 57.6% of patients were male. Malignant diagnosis was present in 139 (83.7%) of patients presented and in 24 (100.0%) patients not presented at MDT (p=0.003). 70.9% of MDT patients with malignancy made it to definitive surgical resection. No difference was seen in rate of oncologically appropriate resection (including recommended lymphadenectomy) by presentation status (56.8% vs. 45.8%, p=0.709). Patients with malignancy more commonly received appropriate pretherapy workup if they were presented at MDT (92.1% vs. 37.5%, p< 0.001). All patients received neoadjuvant therapy if appropriate, and there was no difference seen between groups in the use of adjuvant chemotherapy (78.3% vs 77.7%, p=0.963).

Conclusions: Patients undergoing pancreatectomy who were presented at a multidisciplinary tumor board were significantly more likely to receive appropriate pretherapy workup and post-treatment surveillance as compared to those who were not presented in multidisciplinary tumor board. These findings support future quality efforts to ensure that all patients undergoing pancreatectomy should undergo formalized multidisciplinary review.