The multidisciplinary tumor conference in gynecologic oncology--does it alter management?

OBJECTIVE: To assess the role of the multidisciplinary tumor conference in patient management in a tertiary gynecologic oncology service.

METHODS: Data were analyzed from the records of all patients presented at the gynecologic oncology tumor conferences at Auckland City Hospital from August 1, 2005, to August 1, 2006. Patient information including referral source, cancer site, stage, whether surgery had been performed before the tumor conference and if so where and by whom, and benign versus malignant was extracted from the records. The radiological and pathological findings and diagnosis for each patient both before and after each tumor conference were compared. A discrepancy was defined as a change in tumor site, histological type, grade, or stage that resulted from findings discussed at the conferences. Diagnostic discrepancies that resulted in a change in patient management were classified as major discrepancies. Discrepancies that did not affect patient management were classified as minor discrepancies.

RESULTS: A total of 509 cases were discussed during the study period. Forty-six discrepancies (9%) were noted, with 30 major (5.9%) and 16 minor (3.1%) discrepancies. The most common changes to patient management that resulted from the tumor conferences were the addition of chemotherapy and surgery.

CONCLUSIONS: This study demonstrates that gynecologic oncology tumor conferences alter the diagnosis in a significant number of cases and therefore affect patient management.