CANCER CONFERENCES - CAN THEY BE IMPROVED

PURPOSE: Cancer conferences are required for hospital cancer program a pproval by the American College of Surgeons. These conferences are imp ortant educational and clinical opportunities and can influence the ma nagement of patients with cancer. Nationally, they represent an enormo us expenditure of time and effort by physicians, associated healthcare personnel, and turner registrars. The educational aspects of cancer c onferences have been previously reviewed. The purpose of this investig ation was to evaluate the clinical aspects of cancer conferences. DESC RIPTION OF STUDY: A questionnaire, inquiring about various elements of cases presented at sh consecutive cancer conferences, was sent to 93 Illinois hospitals. These elements included presentation at conference (presenter, time of presentation), clinical aspects (symptoms, histor y, physical examination, and laboratory tests), pathology (TNM stage a nd markers), therapeutic options, and quality-of-life issues. RESULTS: The person (or persons) presenting the case was most frequently the a ttending physician (n = 805, 52%); followed by the pathologist (n = 42 7, 28%); the cancer committee chairperson (n = 318, 21%); the resident (n = 138, 9%); and other members of the multidisciplinary healthcare team (n = 525. 34%), such as the nurse practitioner or radiation thera pist. Of the 1547 cases reviewed, history, physical examination, and d iagnostic tests were discussed in 93%, 91%, and 93% of conference pres entations, respectively. However, staging by the required TNM system, tumor markers, and quality-of-life issues were discussed in only 28%, 34%, and 38% of presentations, respectively. CLINICAL IMPLICATIONS: Al though clinical characteristics were adequately documented and discuss ed at the cancer conferences studied, other important parameters, such as TNM staging. tumor markers, and quality-of-life issues, were less often discussed. Tile former topic frequencies are expected, the latte r unacceptable. Although cancer conferences currently enhance patient care, these findings indicate that there is potential for improvement through discussion of TNM staging, tumor markers, and quality of life.