Multidisciplinary Tumor Board Documentation: Assessing its Frequency, Quality, and Impact

BACKGROUND: Multidisciplinary tumor board (TB) meetings are used to generate consensus recommendations for the diagnosis and management of patients with cancer, yet no documentation standards exist. Since lack of documentation could contribute to patient outcomes, we aimed to characterize TB documentation practices at a single institution. PATIENTS AND METHODS: A retrospective audit of patients discussed at six TBs at a National Cancer Institute (NCI)-designated comprehensive cancer center from January 2024 to June 2024 was conducted. The presence and quality of TB documentation in the medical records were recorded. Associations with clinicodemographic variables and patient outcomes were assessed. RESULTS: Among 991 patients (307 liver, 235 breast, 166 colorectal, 153 pancreas, 110 cutaneous, 20 gastroesophageal), the median age was 63 years, 84.5% were white, 52.5% were female, and 65.7% had locoregional disease. Documentation was present in only 51.7% but varied by disease site (5.5% for breast to 97.0% for colorectal, p < 0.001). Among patients with documentation, 44.7% of notes were unstructured with variable content: 99.2% documented consensus recommendations, 58.0% listed the information reviewed, 29.3% listed attendees' specialties, 11.3% documented the reason for discussion, and 15.8% documented clinical trial eligibility. In total, 55.7% of notes documented if patients were notified of the recommendations, most commonly via phone (71.8%). CONCLUSIONS: In this retrospective study, the presence and quality of documentation in the medical records are highly variable following discussion at a multidisciplinary TB meeting and could serve as a surrogate for high-quality multidisciplinary cancer care. Developing standards for TB documentation may improve accurate and timely dissemination of consensus recommendations and delivery of complex cancer care.