Use and utility of endocrine multidisciplinary tumour board: an appraisal from a tertiary centre

TL;DR

This study evaluates how an endocrine tumor board helps manage endocrine cancers, showing it improves outcomes and decision-making for both common and rare tumors.

Contribution

The study provides empirical evidence on the utility of endocrine multidisciplinary tumor boards in clinical decision-making and patient outcomes.

Findings

Rare diseases, familial syndromes, and adrenal masses were associated with multiple discussions in the tumor board.

Anaplastic Thyroid Carcinoma and Adrenocortical Carcinoma patients had significantly better survival when managed by the EMTB.

About 16% of cases required additional hormonal investigations after EMTB review.

Abstract

The Endocrine Multidisciplinary Tumour Board (EMTB) is a specialised board for endocrine tumours, including thyroid, adrenal, and rare endocrine neoplasms. Although required by major guidelines, little is known about the current EMTB composition and working outcomes. The present study aims to analyse the use and support provided by an experienced EMTB, highlighting the skills of this board.

This monocentric and retrospective study considered all the cases discussed (N=1038, concerning 835 patients) within the ETMB of Careggi University Hospital of Florence from January 1st, 2021, to December 31st, 2023. The queries have been standardised into five major groups. Besides treatment and follow-up indications, particular attention has been paid to the need for repeated discussions, additional indications, imaging revisions, and overall survival (OS) outcomes.

Thyroid and rare cancers were the most frequently represented (64% and 32%, respectively). At logistic regression analysis, the need for multiple discussions was associated with being a rare disease (p<0.001), familiar syndrome (p=0.003), or adrenal masses (p=0.005). When the query was "imaging review," external imaging was more often re-evaluated (p=0.027) due to differing results at EMTB revision, and in about 51% of these cases, further insights were requested. Compared to external control groups, Anaplastic Thyroid Carcinoma and Adrenocortical Carcinoma showed improved OS, 7.84 vs 2.46 months (p=0.049) and 51.92 vs 26.17 months (p=0.0076), respectively. From the hormonal perspective, further hormonal investigations were required in about 16% of eligible cases.

EMTB is pivotal in managing and optimising common and rare endocrine tumour workups.

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