title: A multidisciplinary approach to the management of urologic malignancies: does it influence diagnostic and treatment decisions?
abstract: OBJECTIVE
  It is recognized that multidisciplinary teams may improve management decisions for patients with malignancies. We prospectively studied the effect of such a multidisciplinary approach on the diagnosis and treatment decisions of patients newly presenting with urologic malignancies.
  
  
  METHODS
  Two hundred sixty-nine consecutive new patients presenting to our institution with an outside diagnosis of a urologic malignancy for diagnostic or treatment considerations (2007-2008). All cases were reviewed and discussed at a tumor board with all members of the different subspecialties present. Reevaluation of the outside diagnostic and treatment plan was undertaken. Based on this team review and approach, patients were classified based on changes in diagnosis and/or treatment.
  
  
  RESULTS
  Cohort was comprised of patients with the diagnosis of cancer of the prostate (34%), bladder (23%), kidney (35%), testicle (5%), and other (1%). Only 35% of patients had no changes in diagnosis or treatment, 38% had a change in diagnosis or treatment, 10% required further analysis (i.e., "other"), and 17% were N/A. Changes in diagnosis were most common in bladder (23%) and renal (17%) cancers. Changes in treatment were most common in bladder cancer (44%), followed by kidney (36%), testicular (29%), then prostate (22%) cancers. A stage effect on diagnostic and treatment considerations was also noted, especially for bladder cancer.
  
  
  CONCLUSIONS
  A multidisciplinary team approach affects the diagnostic and management decisions in a significant number patients with a newly diagnosed urologic malignancy, and thereby seems to have a clinical impact for many of our patients with urologic cancers.
authors: Division of Urologic Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
authors: Raj
authors: R
authors: Kurpad
authors: William
authors: W
authors: Kim
authors: W Kim
authors: WK
authors: Rathmell
authors: Paul
authors: P
authors: Godley
authors: Young
authors: Y
authors: Whang
authors: Julia
authors: J
authors: Fielding
authors: LuAnn
authors: L
authors: Smith
authors: Ava
authors: A
authors: Pettiford
authors: Heather
authors: H
authors: Schultz
authors: Matthew
authors: M
authors: Nielsen
authors: Eric M
authors: EM
authors: Wallen
authors: Raj S
authors: RS
authors: Pruthi
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D033183:Interdisciplinary Communication; D008495:Medical Oncology / Q000379:methods / Q000706:statistics & numerical data; D010348:Patient Care Team; D011446:Prospective Studies; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000628:therapy*