Multidisciplinary tumor boards (MTB) are widely used in the management of head and neck cancer and positively impact both patient outcomes and adherence to clinical practice guidelines. The COVID-19 pandemic has largely transitioned tumor boards from an in-person to a virtual setting. Virtual tumor boards may improve access of community-based cancer centers to the resources and expertise of large academic institutions. The purpose of this study is to survey participating physicians to better understand the utility and effectiveness of interinstitutional head and neck cancer programs that co-host virtual MTBs.
Methods: This anonymous survey study included individuals that participated in a head and neck virtual MTB during the COVID-19 pandemic. Data obtained includes demographic variables such as gender, years in practice, specialization, and practice facility type. Subsequent survey questions assessed physician agreement with various statements regarding virtual tumor boards to understand physician preferences and priorities using this platform. Subset analysis using Pearson’s chi-square test was performed to evaluate any differences in survey responses based on cancer care specialty or practice location.
Results: 50 survey responses were obtained out of 89 recipients. Non-response rate was 44%. Survey participants included 11 surgeons, 19 radiation oncologists, 8 medical oncologists, with the remaining participants being pathologists, neuroradiologists, or other cancer care coordinators. Thirty-nine respondents (78%) practiced at community cancer centers with the remaining eleven (22%) practicing at an academic medical center (Table 1). Greater than 96% of participants found MTB to be useful when discussing complex cases and impactful to future patient care. 84% and 66% found MTB to improve access to other medical specialties and clinical trial enrollment for patients, respectively (Table 2). Survey responses differed significantly between oncologists located at an academic center compared to a community hospital. Compared to oncologists at academic centers, oncologists at community cancer centers found virtual MTB to be more useful and impactful to patient care (p<0.001), increased access to other medical specialties (p=0.014), and improved time to adjuvant therapy (p=0.012). Subset analysis revealed no significant differences in survey responses between surgeons, radiation oncologists, and medical oncologists.
Conclusions: Virtual tumor boards are an effective platform for the multidisciplinary management of head and neck cancer patients across high-volume academic and community-based cancer centers. Overall, providers across all specialties and locations view virtual MTB favorably with improvement in care communication and coordination. Virtual MTB may improve access to other medical specialties and clinical trials, particularly for providers based in community and/or regional locations.