title: Review at a multidisciplinary tumor board impacts critical management decisions of pediatric patients with cancer.
abstract: Optimal cancer care requires a multidisciplinary approach. The purpose of the current study was to evaluate the impact of a multidisciplinary tumor board on the treatment plans of children with solid tumors.
  
  
  
  The records of 158 consecutive patients discussed at a formal multidisciplinary pediatric tumor board between July 2012 and April 2014 were reviewed. Treatment plans were based on clinical practice guidelines and on current Children's Oncology Group protocols. Alterations in radiologic, pathologic, surgical, and medical interpretations were analyzed to determine the impact on changes in recommendations for clinical management.
  
  
  
  Overall, 55 of 158 children (35%) had alterations in radiologic, pathologic, medical, or surgical interpretation of clinical data following multidisciplinary discussion. Of these, 64% had changes to the initial recommendation for clinical management. Review of imaging studies resulted in interpretation changes in 30 of 158 patients studied (19%), with 12 clinical management changes. Six of 158 patients (3.9%) had changes in pathologic interpretation, with four patients (2.5%) requiring treatment changes. In eight patients (5%), a change in medical management was recommended, while in 11 patients (7%) there were changes in surgical management that were based solely on discussion and not on interpretation of imaging or pathology.
  
  
  
  Formal multidisciplinary review led to alterations in interpretation of clinical data in 35% of patients, and the majority led to changes in recommendations for treatment. Comprehensive multidisciplinary tumor board incorporated into the care of children with cancer provides additional perspectives for families and care providers when delineating optimal treatment plans.
authors: Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
authors: Arun
authors: A
authors: Thenappan
authors: Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
authors: Ihab
authors: I
authors: Halaweish
authors: Department of Pediatrics, Hematology and Oncology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Rajen J
authors: RJ
authors: Mody
authors: Department of Radiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Ethan A
authors: EA
authors: Smith
authors: Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
authors: James D
authors: JD
authors: Geiger
authors: Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
authors: Peter F
authors: PF
authors: Ehrlich
authors: Department of Pediatrics, Hematology and Oncology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Rama
authors: R
authors: Jasty Rao
authors: Department of Pediatrics, Hematology and Oncology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Raymond
authors: R
authors: Hutchinson
authors: Department of Pediatrics, Hematology and Oncology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Gregory
authors: G
authors: Yanik
authors: Department of Pathology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Raja M
authors: RM
authors: Rabah
authors: Department of Pathology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
authors: Amer
authors: A
authors: Heider
authors: Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
authors: Tammy
authors: T
authors: Stoll
authors: Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
authors: Erika A
authors: EA
authors: Newman
mesh_terms: D002648:Child; D019468:Disease Management; D006801:Humans; D033183:Interdisciplinary Communication; D009369:Neoplasms / Q000628:therapy*; D010347:Patient Care Planning; D010348:Patient Care Team; D013044:Specialty Boards / Q000458:organization & administration*
keywords: management; multidisciplinary; oncology; pediatric tumor board