Introduction/Background*Physicians encounter pregnant women with cancer only incidentally, leading to lack of expertise or confidence to inform and treat these patients according to up to date guidelines and expert opinions. In the Netherlands, a national multidisciplinary tumor board (MDT) for cancer and pregnancy was founded in 2012, and consists of 33 physicians from all over the country. Requests to discuss patients in the MDT were received by e-mail and a recommendation letter was generated based on available literature and expert opinion of the board members.
Methodology All requests and recommendations were gathered in a database and analyzed for tumor type, stage, gestational age and recommendation given. A survey was sent out to 93 physicians who requested recommendations of the MDT, containing questions regarding the their experiences with the MDT and the impact on treatment decisions.
Result(s)*From December 2012 to May 2021, 209 recommendations were formulated, mostly regarding pregnant patients with breast cancer (n=65), cervical cancer (n=32), haematological malignancies (n= 32), rare cancer types (n=30) and melanoma (n=21). Questions were asked regarding possibilities of ionized imaging, chemotherapy, hormonal therapy or immunotherapy during pregnancy and possible effects on the child, the sequence of the different treatment components and questions on fertility. Response rate of the questionnaire was 54%. Overall satisfaction with the recommendations of the MDT was high, and 94% of the respondents informed their patients about consulting the MDT and felt supported by the received recommendations.
Conclusion*A national MDT for cancer and pregnancy is frequently consulted and highly appreciated by physicians. Next to that, it increases expertise of its members about this rare coincidence of cancer and pregnancy. We highly recommend to establish an (inter)national MDT in each country. Figure 1 shows the important steps necessary to establish an MDT for cancer in pregnancy based on our experience.
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