A. Sasidharan1, K. Trencheva1, C. Merchant1, J. W. Milsom1, P. J. Shukla1 1Weill Cornell Medical College,Colorectal Surgery,New York, NEW YORK, USA
Introduction: In our Institutional Colorectal Multidisciplinary Team (MDT), selective referral of patients by treating physicians is made. The primary aims of this study were to evaluate the reasons for referral of patients with colorectal cancer to a multidisciplinary colorectal tumor board, and to evaluate whether the plan of care was changed as a result of tumor board review. The secondary aim was to compare the characteristics of patients who were referred to the MDT versus those who were not.
Methods: This was a prospective study involving subjects ≥ 18 years of age with colorectal cancer treated at our hospital from January to July 2015. Subjects who were referred to the MDT were compared to those who were not referred (but underwent surgical treatment). Demographics, preoperative and postoperative data, and surgical pathology results of the two groups were collected. Outcomes were analyzed at 1 and 3 months for both the referred (after discussion at MDT) and non-referred (after surgery) subjects. Univariate and multivariate logistic regression was performed to analyze the data.
Results: There were 106 subjects in the referred group and 35 in the non-referred group. The most common reasons for referral were: discuss management plan (89.6%), review radiology (70.7%), review pathology (53.7%) and discuss timing of surgery (1.8%). After discussion at MDT, plan of care changed in 32.1% (34/106) of the subjects. The revised plan was implemented in 67.6% (23/34) and was not implemented in 26.4 % (9/34) of the subjects. 2/34 are awaiting the commencement of treatment as recommended. The reasons for non-implementation were: patient’s choice, treating physician’s decision and age. The following variables were found to be significant in univariate analysis between the 2 groups, with p-value < 0.05: age, history of previous surgery, previous chemotherapy, previous abdominal surgery, tumor location and stage of cancer. Multivariate logistic regression with "referral to MDT’ being the outcome is reported in Table1.
Conclusions: The main reason for referral to MDT was to discuss management plan. Plan of care changed in nearly one third of the subjects as a result of MDT review. Tumor location and Stage of cancer are significant factors determining MDT referral.
