Abstract：
OBJECTIVE: At present, multidisciplinary tumor boards (MDTB) are considered best practice in oncology. However, web-based virtualization of MDTB may increase participation in meetings, the number of cases discussed, and adherence to guidelines, deliver better treatment, and eventually improve outcomes for patients with prostate cancer.
METHODS: This is an observational study focused on exploring the structuring process and implementing a multi-institutional virtual MDTB in Sicily, Italy. Other endpoints included the analysis of cooperation between participants, adherence to guidelines, patient outcomes, and patient satisfaction.
RESULTS: Overall, 126 patients were referred to the virtual MDTB for a total of 302 cases discussed in an 18-month period. Nearly 45% of cases were referred from general hospitals or tertiary centers, 38% from comprehensive cancer centers, and only 17% from academic ones. Most health professional participants (95%) reported eliminating geographical barriers and consequently reducing costs and saving time as key advantages of virtual meetings over face-to-face ones. Using a specifically designed platform for virtual MDTBs was another excellent point, especially to geolocate clinical trials and time-lapse data storage. The majority of referred patients had stage T 3-4 prostate cancer (79%). Overall, 71% of proposals discussed were approved unchanged, while 19% changed after the virtual MDTB discussion. Debated points were mostly radiologic, surgical, medical, or radiation treatment-related issues. In particular, the prescriptive appropriateness of positron emission tomography with 68Ga-prostatic specific membrane antigen, newer drugs, radiation versus surgical approach, stage T3-4 cases, and adjuvant therapy represented the most debated issues. The proposed diagnostic and/or therapeutic options were controlled for adherence to the guidelines and/or updated scientific evidence. Overall, 98% of approved proposals and changes were in line with the guidelines. Overall, most participants felt virtual MDTB was very useful and case discussions led to a major change of strategy in 19% of cases.
CONCLUSIONS: Virtual MDTBs are a very useful way to achieve best management of prostate cancer while saving time and fostering cooperation.
METHODS: This is an observational study focused on exploring the structuring process and implementing a multi-institutional virtual MDTB in Sicily, Italy. Other endpoints included the analysis of cooperation between participants, adherence to guidelines, patient outcomes, and patient satisfaction.
RESULTS: Overall, 126 patients were referred to the virtual MDTB for a total of 302 cases discussed in an 18-month period. Nearly 45% of cases were referred from general hospitals or tertiary centers, 38% from comprehensive cancer centers, and only 17% from academic ones. Most health professional participants (95%) reported eliminating geographical barriers and consequently reducing costs and saving time as key advantages of virtual meetings over face-to-face ones. Using a specifically designed platform for virtual MDTBs was another excellent point, especially to geolocate clinical trials and time-lapse data storage. The majority of referred patients had stage T 3-4 prostate cancer (79%). Overall, 71% of proposals discussed were approved unchanged, while 19% changed after the virtual MDTB discussion. Debated points were mostly radiologic, surgical, medical, or radiation treatment-related issues. In particular, the prescriptive appropriateness of positron emission tomography with 68Ga-prostatic specific membrane antigen, newer drugs, radiation versus surgical approach, stage T3-4 cases, and adjuvant therapy represented the most debated issues. The proposed diagnostic and/or therapeutic options were controlled for adherence to the guidelines and/or updated scientific evidence. Overall, 98% of approved proposals and changes were in line with the guidelines. Overall, most participants felt virtual MDTB was very useful and case discussions led to a major change of strategy in 19% of cases.
CONCLUSIONS: Virtual MDTBs are a very useful way to achieve best management of prostate cancer while saving time and fostering cooperation.
摘要：
目标：目前，多学科肿瘤委员会（MDTB）被认为是肿瘤学的最佳实践。然而,基于网络的MDTB虚拟化可能会增加会议的参与度，讨论的案件数量，遵守指导方针，提供更好的治疗，并最终改善前列腺癌患者的预后。
方法：这是一项观察性研究，重点是探索西西里岛的结构化过程和实施多机构虚拟MDTB，意大利。其他终点包括参与者之间的合作分析，遵守准则，患者结果,患者满意度。
结果：总体而言，在18个月的时间里，有126名患者被转诊到虚拟MDTB，共讨论了302例。近45%的病例是从综合医院或三级中心转诊的,38%来自综合癌症中心，只有17%来自学术。大多数健康专业参与者（95％）报告说，消除了地理障碍，从而降低成本并节省时间是虚拟会议相对于面对面会议的关键优势。为虚拟MDTB使用专门设计的平台是另一个很好的观点，特别是地理定位临床试验和延时数据存储。大多数转诊患者患有T3-4期前列腺癌（79％）。总的来说,所讨论的提案中有71％获得批准，而19%在虚拟MDTB讨论后发生了变化。争论的要点主要是放射学的，外科,medical,或与放射治疗相关的问题。特别是,具有68Ga-前列腺特异性膜抗原的正电子发射断层扫描的处方适当性，新药,辐射与手术方法，T3-4期病例，和辅助治疗代表了最有争议的问题。为了遵守指南和/或更新的科学证据，对拟议的诊断和/或治疗方案进行了控制。总的来说,98％的批准提案和变更符合准则。总的来说,大多数参与者认为虚拟MDTB非常有用，病例讨论导致19％的病例发生了策略的重大变化。
结论：虚拟MDTB是一种非常有用的方法，可以实现前列腺癌的最佳管理，同时节省时间和促进合作。
方法：这是一项观察性研究，重点是探索西西里岛的结构化过程和实施多机构虚拟MDTB，意大利。其他终点包括参与者之间的合作分析，遵守准则，患者结果,患者满意度。
结果：总体而言，在18个月的时间里，有126名患者被转诊到虚拟MDTB，共讨论了302例。近45%的病例是从综合医院或三级中心转诊的,38%来自综合癌症中心，只有17%来自学术。大多数健康专业参与者（95％）报告说，消除了地理障碍，从而降低成本并节省时间是虚拟会议相对于面对面会议的关键优势。为虚拟MDTB使用专门设计的平台是另一个很好的观点，特别是地理定位临床试验和延时数据存储。大多数转诊患者患有T3-4期前列腺癌（79％）。总的来说,所讨论的提案中有71％获得批准，而19%在虚拟MDTB讨论后发生了变化。争论的要点主要是放射学的，外科,medical,或与放射治疗相关的问题。特别是,具有68Ga-前列腺特异性膜抗原的正电子发射断层扫描的处方适当性，新药,辐射与手术方法，T3-4期病例，和辅助治疗代表了最有争议的问题。为了遵守指南和/或更新的科学证据，对拟议的诊断和/或治疗方案进行了控制。总的来说,98％的批准提案和变更符合准则。总的来说,大多数参与者认为虚拟MDTB非常有用，病例讨论导致19％的病例发生了策略的重大变化。
结论：虚拟MDTB是一种非常有用的方法，可以实现前列腺癌的最佳管理，同时节省时间和促进合作。
