gms | German Medical Science

Background and current state of (inter)national research: Due to the German National Cancer Plan, cancer centers have been established. Lung cancer centers are responsible for coordinating the care of lung cancer patients in a region and to diagnose and treat them according to the latest evidence-based knowledge. For this purpose, every patient should be discussed in a multidisciplinary tumor board. In the tumor board an individual treatment plan is discussed and treatment recommendations are given.

Research questions and objectives: Therefore, we investigate:

1.

how are the recommendations from tumor boards being adhered to;

2.

which factors determine the adherence of tumor board recommendations and

3.

what is the relationship between the adherence of tumor board recommendations and patient outcomes in terms of overall survival?

Methods: Data from 1784 newly-diagnosed patients with lung cancer discussed in tumor boards in one certified lung cancer center in Northern Germany between 2014 and 2018 were documented and evaluated according to the adherence to tumor board recommendations. A preliminary analysis of the first 142 cases analyzed will be presented. Data was analyzed descriptively.

Results: Median age of the 142 patients was 67 years (36-88 yrs) and 58% (n=82/142) of them were male. Most of the patients had an ECOG status of 0 or 1 (71%; n=101/142) and 82% of them were current or ex heavy smoker (n=117/142). 66% (n=94/142) of the patients that have been discussed in the multidisciplinary tumor board, were afterwards further treated at the same certified lung cancer center. In 78% (n=110/142) of patients, the treatment recommendations from the multidisciplinary tumor boards were completely adhered to. There were different reasons for non-adherence, e.g. patient’s wish, patient characteristics and death before starting therapy. The median overall survival for the 142 patients was 15 months. Patients with a complete adherence to the multidisciplinary tumor board recommendation had an overall survival of 17 months (n=110) compared to 11 months (n=16) for patients with a partial adherence compared to 1 months (n=16) for patients with a non-adherent treatment (p<0.000).

Discussion: Preliminary results give a hint to the fact that patients with an adherent treatment after first diagnosis had a longer overall survival than patients with another therapy. More cases will be presented at the meeting using a multivariate analysis which includes patient characteristics and healthcare organizations that took over further treatment as predictors.