Bladder Cancer Multidisciplinary Clinic (BCMC) Model Influences Disease Assessment and Impacts Treatment Recommendations
Year: 2019
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Despite established guidelines for bladder cancer (BC) management, significant treatment variability remains across the United States. OBJECTIVE: To report the impact of a tertiary center, bladder cancer multidisciplinary clinic (BCMC) on diagnostic evaluation and treatment recommendations in externally referred patients with BC. METHODS: Our BCMC clinic format includes simultaneous consultation with urologic, medical and radiation oncology, with real-time expert genitourinary pathology and radiology review. We retrospectively assessed all external referrals for concordance between outside radiology/pathology records and BCMC interpretation after central review and explored potential differences between outside treatment plan and BCMC recommendations. RESULTS: 233 patients with BC were referred to BCMC between the years 2014–2017. Complete radiographic and pathology data were available for 201 patients. Median age was 69 (Interquartile Range: 60–75) and 83% were performance status ECOG 0-1. After BCMC review of outside records, imaging interpretation was changed in 53 (26%) patients; pathology was changed in 59 (29%). Further diagnostic work-up was recommended in 85 (42%) patients. Overall, 56 (28%) patients had a change in their clinical staging. BCMC recommended treatment modification in 117 (58%) patients. Subsequent treatment plan was concordant with BCMC recommendations 91.5% of the time. CONCLUSIONS: BCMC resulted in critical radiology and/or pathology diagnostic changes in several cases, with frequent treatment modifications, underscoring the importance of multidisciplinary care in BC and the considerable contribution of real-time expert pathology and radiology review in diagnostic accuracy. Further studies are needed to confirm the proposed benefits and impact of BCMC on treatment response and patient outcomes.
Source: Bladder Cancer
DOI: 10.3233/blc-190239
Authors: Leonidas N. Diamantopoulos, Brian R. Winters, Petros Grivas, Steven D. Ngo, Jing Zeng, Andrew C. Hsieh, John L. Gore, Jay J. Liao, Evan Y. Yu, George R. Schade, Sarah P. Psutka, Michael T. Schweizer, Jean H. Lee, Manjiri Dighe, Daniel W. Lin, Heather H. Cheng, Joanna Daya, Maria S. Tretiakova, Lawrence D. True, Kenneth J. Russell, Funda Vakar-Lopez, Robert B. Montgomery, Jonathan L. Wright
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W2992259013