Multidisciplinary Tumor Boards in Dermatologic Surgery

Abstract

BACKGROUND Recent advances in diagnostic and therapeutic modalities have made oncologic care ever more challenging, and multidisciplinary tumor boards (MTBs) are increasingly being used as a forum to discuss and coordinate care for complex oncology patients. Literature on the use of MTBs specific to cutaneous oncology and dermatologic surgery remains limited. OBJECTIVE To share our experiences with cutaneous oncology MTBs at the University of Vermont Medical Center (UVMMC). METHODS We describe the formation, timing, participation, clinical discussion, case follow-up, and coordination of care of our MTBs. RESULTS A log of all cases discussed at cutaneous oncology MTBs from August 2018 to August 2019 is presented as an example. Five specific cases are described in further detail to demonstrate critical components of multidisciplinary care. CONCLUSION The MTBs at UVMMC has created a collaborative environment for providers in multiple specialties to jointly formulate and coordinate optimal treatment plans for difficult cases, particularly when treatment guidelines do not exist or are insufficient. Furthermore, MTBs can serve as an educational forum for all participants.

A diagnostically challenging spindle cell carcinoma of the neck: Treatment with Mohs micrographic surgery and clinical course

“…In most academic or university settings, presentation of diagnostic and management conundrums at multidisciplinary tumor boards is particularly beneficial for collaborative learning and therapeutic guidance. A recent report highlighted the benefits of such a multidisciplinary approach in dermatologic surgery, 3 but it also noted the practical difficulties in gathering the numerous specialists, which can be particularly challenging for private-practice clinicians. Our patient would have benefitted from tumor board discussion, in which evaluation and treatment could have initially been guided by numerous informed subspecialists.…”