Tumor board participation among physicians caring for patients with lung or colorectal cancer.
OBJECTIVE
Multidisciplinary tumor board meetings are common in cancer care, but limited evidence is available about their benefits. We assessed the associations of tumor board participation and structure with care delivery and patient outcomes.


METHODS
As part of the CanCORS study, we surveyed 1,601 oncologists and surgeons about participation in tumor boards and specific tumor board features. Among 4,620 patients with lung or colorectal cancer diagnosed from 2003 to 2005 and seen by 1,198 of these physicians, we assessed associations of tumor board participation with patient survival, clinical trial enrollment, guideline-recommended care, and patient-reported quality, adjusting for patient and physician characteristics.


RESULTS
Weekly physician tumor board participation (v participation less often or never) was not associated with patient survival, although in exploratory subgroup analyses, weekly participation was associated with lower mortality for extensive-stage small-cell lung cancer and stage IV colorectal cancer. Patients treated by the 54% of physicians participating in tumor boards weekly (v less often or never) were more likely to enroll onto clinical trials (odds ratio [OR], 1.6; 95% CI, 1.1 to 2.2). Patients with stage I to II non-small-cell lung cancer (NSCLC) whose physicians participated in tumor boards weekly were more likely to undergo curative-intent surgery (OR, 2.9; 95% CI, 1.3 to 6.8), although those with stage I to II NSCLC whose physicians' meetings reviewed > one cancer site were less likely to undergo curative-intent surgery (OR, 0.1; 95% CI, 0.03 to 0.4).


CONCLUSIONS
Among patients with lung or colorectal cancer, frequent physician tumor board engagement was associated with patient clinical trial participation and higher rates of curative-intent surgery for stage I to II NSCLC but not with overall survival.
The University of Texas MD Anderson Cancer Center, Houston, TX; Harvard Medical School; Dana-Farber Cancer Institute; Brigham and Women's Hospital, Boston, MA; RAND Corporation, Santa Monica; and University of California Los Angeles, Los Angeles, CA.
Kenneth L
KL
Kehl
The University of Texas MD Anderson Cancer Center, Houston, TX; Harvard Medical School; Dana-Farber Cancer Institute; Brigham and Women's Hospital, Boston, MA; RAND Corporation, Santa Monica; and University of California Los Angeles, Los Angeles, CA.
Mary Beth
MB
Landrum
The University of Texas MD Anderson Cancer Center, Houston, TX; Harvard Medical School; Dana-Farber Cancer Institute; Brigham and Women's Hospital, Boston, MA; RAND Corporation, Santa Monica; and University of California Los Angeles, Los Angeles, CA.
Katherine L
KL
Kahn
The University of Texas MD Anderson Cancer Center, Houston, TX; Harvard Medical School; Dana-Farber Cancer Institute; Brigham and Women's Hospital, Boston, MA; RAND Corporation, Santa Monica; and University of California Los Angeles, Los Angeles, CA.
Stacy W
SW
Gray
The University of Texas MD Anderson Cancer Center, Houston, TX; Harvard Medical School; Dana-Farber Cancer Institute; Brigham and Women's Hospital, Boston, MA; RAND Corporation, Santa Monica; and University of California Los Angeles, Los Angeles, CA.
Aileen B
AB
Chen
The University of Texas MD Anderson Cancer Center, Houston, TX; Harvard Medical School; Dana-Farber Cancer Institute; Brigham and Women's Hospital, Boston, MA; RAND Corporation, Santa Monica; and University of California Los Angeles, Los Angeles, CA keating@hcp.med.harvard.edu.
Nancy L
NL
Keating
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003299:Cooperative Behavior; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033183:Interdisciplinary Communication; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010348:Patient Care Team; D010818:Practice Patterns, Physicians'; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States