A multidisciplinary approach to the management of urologic malignancies: does it influence diagnostic and treatment decisions?
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.
Kurpad
Raj
R
Division of Urologic Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Kim
William
W
Rathmell
W Kim
WK
Godley
Paul
P
Whang
Young
Y
Fielding
Julia
J
Smith
LuAnn
L
Pettiford
Ava
A
Schultz
Heather
H
Nielsen
Matthew
M
Wallen
Eric M
EM
Pruthi
Raj S
RS
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*