Abstract 393P
Background
Colorectal cancer centers are responsible for coordinating the care of colorectal cancer (CRC) patients in a region and to diagnose and treat them according to the latest evidence-based knowledge. In the multidisciplinary tumor board (MTB) an individual treatment plan is discussed, and treatment recommendations are given. Therefore, we investigate: 1.) how are the recommendations from tumor boards being adhered to; 2.) which factors determine the adherence of tumor board recommendations (TBR) and 3.) what is the relationship between the adherence of TBR and patient outcomes in terms of OS?.
Methods
Data from 562 CRC-patients discussed in tumor boards in one certified CRC-center in Northern Germany between 2014 and 2018 were documented and evaluated according to the adherence to TBR.
Results
Median age of the 562 pts was 70 years (57-83 yrs) and 51.1% (n=287) of them were male. 349 (62%) pts had colon cancer and 213 (38%) rectum cancer. In 94% (n=530) of pts, the TBR from the MTB were completely adherend to. There were different reasons for non-adherence (n=32), the majority was patient wish 84% (n=27), followed by physician decision 9% (n=3). Pts with a complete adherence to the MTB-recommendation had an OS of 65 months (n=530) compared to 40 months (n=32) for pts with a partial adherence or a non-adherent treatment (p<0.008). In a multilevel analysis we used a logistic binary regression model with adherence as the dependent variable. In a 3-step model, we firstly included covariates reflecting disease status, secondly sociodemographic level and lastly, we included the healthcare organization responsible for treatment. R2 value increased from 9% in step 1, to 18.4% in step 2 and 21% in step 3. CCI and healthcare organization were the significant covariates in the last step. In the multivariate analysis on the endpoint OS, we included 9 covariates describing patient characteristic. The model was statistically significant (p=0.000) and the covariates age at diagnosis, UICC-stage and ECOG contributed significantly and were independent factors.
Conclusions
Results show that patients with an adherent treatment after first diagnosis had a longer OS than pts. with another therapy. Cases will be presented more detailed at the meeting.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J. Roeper: Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim, Roche; Financial Interests, Personal, Writing Engagements, Invited Speaker: AstraZeneca. F. Griesinger: Financial Interests, Personal, Invited Speaker, Advisory Board and Research Grant: Boehringer Ingelheim, AstraZeneca, Roche, BMS, MSD, Celgene, Lilly, Takeda, Siemens, Novartis, Pfizer; Financial Interests, Personal, Invited Speaker, Advisory Board: Ariad, AbbVie, Amgen, Tesaro/GSK. All other authors have declared no conflicts of interest.