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UPJ INSIGHT Use of a Virtual Tumor Board for Renal Masses in the Michigan Urological Surgery Improvement Collaborative
By: Mahmoud A. Hijazi, Oakland University William Beaumont School of Medicine, Rochester Hills, Michigan; Zachary J. Prebay, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; Anna Johnson, University of Michigan, Ann Arbor; Samantha Wilder, MD, Henry Ford Health System, Detroit, Michigan; Amit K. Patel, MD, Henry Ford Health System, Detroit, Michigan; Rohit Mehra, University of Michigan, Ann Arbor; James E. Montie, University of Michigan, Ann Arbor; Sabrina L. Noyes, BS, Spectrum Health, Grand Rapids, Michigan; Mahin Mirza, MPH, University of Michigan, Ann Arbor; S. Mohammad Jafri, MD, Comprehensive Urology, Royal Oak, Michigan; Alon Weizer, University of Michigan, Ann Arbor; Richard Sarle, Sparrow Medical Group, Lansing, Michigan; Khurshid R. Ghani, University of Michigan, Ann Arbor; Craig G. Rogers, MD, Henry Ford Health System, Detroit, Michigan; Brian R. Lane, MD, PhD, FACS, Spectrum Health, Grand Rapids, Michigan, Michigan State University College of Human Medicine, Grand Rapids For the Michigan Urological Surgery Improvement Collaborative | Posted on: 20 Jul 2023
Hijazi MA, Prebay ZJ, Johnson A, et al. Utilization of a virtual tumor board for the care of patients with renal masses: experience from a quality improvement collaborative. Urol Pract. 2023;10(4):380-388.
Study Need and Importance
Multidisciplinary tumor boards are offered at some institutions, and the literature confirms they can improve patient outcomes. There is limited published evidence regarding such tumor boards in the field of urology, with only 1 other publication regarding a virtual tumor board (VTB). We report our experience in developing a functioning and valuable VTB for urologists who participate in the Michigan Urological Surgical Improvement Collaborative (MUSIC).
What We Found
Over the course of 2 years, MUSIC urologists have submitted 50 renal mass cases to the VTB for discussion by their colleagues. These submissions generated over 350 messages from more than 58 specialists in urology, medical oncology, and genitourinary pathology. These responses provided an initial treatment plan for 42% of cases, an alternative approach to the submitting physician’s initial plan in 16%, and confirmed the clinician’s approach in 38% of cases (see Figure). Impressively, the VTB appears to have increased the use of surveillance (which was implemented in 11 patients initially to undergo surgery). Kidney-sparing interventions were used when appropriate, as evidenced by the fact that each radical nephrectomy performed was warranted according to the participants in the VTB.
Limitations
Our study is limited by its sample size and reach, and the ability to determine whether the VTB recommendations truly resulted in better patient outcomes, as the length and availability of follow-up data were somewhat limited.
Interpretation for Patient Care
Overall, it is evident that virtual discussion forums, such as the MUSIC VTB, provide value in the field of urology, and we hope others develop and utilize similar platforms to generate more discussion of complex patient scenarios to achieve the best outcome for each patient.
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