Survey on paediatric tumour boards in Europe: current situation and results from the ExPo-r-Net project.

BACKGROUND: Under the ExPO-r-NeT project (European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment), we aimed to identify paediatric oncology tumour boards in Europe to investigate the kind of technologies and logistics that are in place in different countries and to explore current differences between regions. METHODS: A 20-question survey regarding several features of tumor boards was designed. Data collected included infrastructure, organization, and clinical decision-making information from the centres. The survey was distributed to the National Paediatric Haematology and Oncology Societies that forwarded the survey to the sites. For comparative analysis, respondents were grouped into four geographical regions. RESULTS: The questionnaire was distributed amongst 30 countries. Response was obtained from 23 (77%) that altogether have 212 paediatric oncology treating centres. A total of 121 institutions answered (57%). Ninety-one percent of the centres hold multidisciplinary boards; however, international second consultations are performed in 36% and only 15% participate on virtual tumor boards. Videoconferencing facilities and standard operational procedures (SOPs) are available in 49 and 43% of the centres, respectively. There were statistically significant differences between European regions concerning meeting infrastructure and organization/logistics: specific room, projecting equipment, access to medical records, videoconferencing facilities, and existence of SOPs. CONCLUSION: Paediatric tumor boards are a common feature in Europe. To reduce inequalities and have equal access to healthcare, a virtual network is needed. Important differences on the functioning and access to technology between regions in Europe have been observed and need to be addressed.

Paediatric tumour boards in Spain: a national survey.

PURPOSE: Multidisciplinary tumour boards (MDTs) are conducted worldwide for the management of patients with cancer, and they deliver a higher standard of care by simultaneously involving different specialists in diagnosis and treatment planning. However, information of paediatric MDTs functioning is scarce. A pilot study was conducted in Spain in the frame of the European Expert Paediatric Oncology Reference Network for Diagnostics and Treatment (ExPO-r-Net). METHODS: A specific questionnaire was designed regarding various features of MDT practice. Data collected included information on the centres and the team, infrastructure for meetings, MDT organization/logistics and clinical decision-making. The survey was distributed to all Paediatric Oncology Units that register patients in the Spanish Registry of Childhood Tumours (RETI-SEHOP). RESULTS: 32 out of 43 contacted centres responded the questionnaire (74 % response rate; 88 % response rate for centres with >25 new patients/year). All units with >25 new patients/year have a dedicated Paediatric MDT compared to 76 % of units with ≤25 new patients/year. MDTs should be improved at institutional level by clear protected time in service planning for all specialists involved, incentives for attendance and attendance registration. Clinical decision-making process and follow-up of recommendation adherence should be assessed and potential legal responsibilities for physicians participating in Tumour Board defined. Network collaboration through virtual MDTs, using available videoconferencing tools, is an opportunity to share expertise among centres.

Cancer in children and adolescents in Spain: incidence, treatment setting and provider specialty.

PURPOSE: To analyze cancer incidence, distribution of malignancy, treatment setting and provider specialty of cancer patients, 0-19 years old, in the Comunitat Valenciana, Spain. METHODS/PATIENTS: All incident childhood and adolescent (0-19 years) cancer cases registered in the population-based Comunitat Valenciana Childhood Cancer Registry (RTICV) from 2007 to 2010 were included. Pathological and hematological diagnoses were recoded using the International Classification of Childhood Cancer Third Edition (ICCC-3). Treatment setting and provider specialty were analyzed. RESULTS: 696 patients <20 years were diagnosed with cancer: 513 cases were children (0-14 years) and 183 were adolescents (15-19 years). Overall age-adjusted incidence for 2007-2010 was 176.0 cases per million (95 % CI 162.8-189.2), with incidence being the highest among infants (287.4), followed by 1-4 years (205.5), adolescents (179.9), 10-14 years (150.2) and 5-9 years (140.6). Among adolescents aged 14-19 years, the treatment setting differed by cancer type; 87 % of them were never seen at pediatric oncology units, while 40 % were treated in up to 20 different medical oncology departments in institutions without pediatric oncology expertise. CONCLUSIONS: This is the first population-based epidemiological study carried out in Spain on children and adolescents with cancer. Centralization of care to a small number of specialized centers and thorough pediatric and oncology team collaboration are needed to improve care and survival for adolescents with cancer in our country. We suggest the creation of specific adolescent tumor boards in main tertiary care hospitals, in which adolescents with cancer can benefit from the shared expertise of medical and pediatric specialists.