Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Translation of oncology Multidisciplinary Team Meeting (MDM) recommendations into clinical practice (#306)

Shalini K Vinod 1 2 3 , Nisali T Wellege 2 , Sara Kim 2 , Kirsten J Duggan 3 4 , Mirette Ibrahim 1 , Jesmin Shafiq 2 3
  1. Liverpool Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia
  2. South Western Sydney Clinical School, University of NSW, Liverpool, NSW, Australia
  3. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  4. South West Sydney Local Health District Clinical Cancer Registry, Liverpool, NSW, Australia

Background

Multidisciplinary team meeting (MDM) processes differ according to clinical setting and tumour site. This can impact on decision making. This study aimed to evaluate the translation of MDM recommendations into clinical practice across solid tumour MDMs at an academic centre.

Methods

A retrospective audit of oncology records was performed for nine oncology MDMs held at Liverpool Hospital, NSW, Australia from 1/2/17-31/7/17. Information was collected on patient factors (age, gender, country of birth, language, postcode, performance status, comorbidities), tumour factors (diagnosis, stage) and MDM factors (number of MDMs, MDM recommendation). Management was audited up to a year post MDM to record management and identify reasons if discordant with MDM recommendations. Univariate and multivariable regression analyses were performed to assess for factors associated with concordant management.

Results

835 patients were discussed, median age was 65 years and 51.4% were males. 70.8% of patients were presented at first diagnosis, 77% discussed once and treatment recommended in 73.2%. Of 771 patients assessable for concordance, management was fully concordant in 79.4%, partially concordant in 12.8% and discordant in 7.8%. Concordance varied from 84.5% for lung MDM to 97.6% for breast MDMs. On multivariable analysis, breast and upper GI MDMs and discussion at multiple MDMs were significantly associated with concordant management. The most common reason for discordant management was patient/guardian decision (28.3%).

Conclusion

There was variability in translation of MDM recommendations into clinical practice by tumour site. Routine measurement of implementation of MDM recommendations should be considered as a quality indicator of MDM practice