A. C. Sykes1,2, C. Gaudioso3, P. E. Whalen3, K. Attwood3, C. Nwogu4 1Upstate Medical University,Syracuse, NY, USA 2Roswell Park Comprehensive Cancer Center,Summer Research Experience Program In Cancer Science,Buffalo, NY, USA 3Roswell Park Comprehensive Cancer Center,Biostatistics & Bioinformatics,Buffalo, NY, USA 4Roswell Park Comprehensive Cancer Center,Thoracic Surgery,Buffalo, NY, USA
Introduction: Lung Cancer, as the leading cause of cancer deaths in the U.S. remains a major health challenge. With the increasing complexity of lung cancer care, the multidisciplinary approach has taken on an increasingly prominent role in the care of lung cancer patients. This study aims to capture how a thoracic multidisciplinary conference (MDC) impacts lung cancer care and survivorship, to determine if there is a quantifiable advantage of applying formalized multidisciplinary care.
Methods: All patients registered with ICD 10 codes C34.0-9 “lung cancer” between January 1, 2010 and December 31, 2016 were identified from the cancer registry system. A total of 936 patients presented at the MDC were compared to a matched subset of the patients not discussed at the MDC. We used the REDCap electronic data capture tools hosted at Roswell Park Comprehensive Cancer Center (RPCCC). From the entire cohort, the top 600 patients with matched demographics and clinical presentations were used to generate intervention and control groups of 300 patients each. The survival rates and treatment plans of patients in both groups were retrospectively reviewed to quantify the benefits of the thoracic MDC. To objectively compare the quality of each treatment plan, the National Comprehensive Cancer Network (NCCN) guidelines were used to define the standard of care at each stage of the treatment process. The changes made to each treatment plan after the MDC were documented and compared to the final treatment plan to determine how the MDC influenced each case.
Results: There was an improvement in overall survival for lung cancer patients discussed at the Thoracic MDC (p<0.03). However, there was no significant improvement in lung cancer specific survival rates for these patients (p=0.12). MDC discussion made a statistically significant difference in the NCCN guidelines compliance rate of the final treatment received by patients (Table 1). 82 of 185 patients (44.3%) underwent treatment plan changes by the MDC, including 18 patients whose treatment plans were ‘uncertain’ prior to the MDC. Post-MDC recommendations included changes in the type of systemic therapy, surgical procedure, radiotherapy or a change in the sequence of multimodality therapy.
Conclusion: A large proportion of patients had their treatment plans altered after MDC discussion. The final treatments that patients received were more compliant with NCCN guidelines after such discussions. Though our results showed an improvement in overall survival for the lung cancer patients discussed at the Thoracic MDC, an improvement in lung cancer specific survival as a result of MDC discussion could not be demonstrated in this limited cohort of matched patients.
