Charlotte Benoit1, Daniel Orbach2, Stacy Cyrille3, Kahina Belhous4, Véronique Minard-Colin5, Natacha Kadlub6, Frédéric Kolb7, Yves Reguerre8, Matthieu Carton3, Stéphanie Bolle9, Sylvie Helfre10, Thierry Van Den Abbeele11, Romain Luscan12, Dana M Hartl13, Louise Galmiche14, Arnaud Petit15, Miguel Maiz16, Vincent Couloigner12, Monique Elmaleh17, Sophie Bernard18. 1. Université de Paris, NeuroDiderot, Inserm, 75019 Paris, France; Pediatric Ear, Nose, and Throat Department, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France. Electronic address: charlotte.benoit@aphp.fr. 2. SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), PSL Research University, Institut Curie, Paris, France. 3. Institut Curie, PSL Research University, DRCI, Biometrics, Saint-Cloud, France. 4. Pediatric Radiology, Necker-Enfants-Malades Hospital, Public Assistance-Hospitals of Paris, Paris, France. 5. Department of Pediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France. 6. Department of Maxillo Facial Surgery, Necker-Enfants Malades Hospital, Public Assistance-Hospitals of Paris, Paris, France. 7. Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France. 8. Pediatric Oncology and Hematology Unit, CHU of Saint Denis, La Réunion, France. 9. Department of Radiation Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France. 10. Department of Radiation Oncology, Institut Curie, Paris, France. 11. Université de Paris, NeuroDiderot, Inserm, 75019 Paris, France; Pediatric Ear, Nose, and Throat Department, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France. 12. Pediatric Otolaryngology Department, Necker-Enfants Malades Hospital, Public Assistance-Hospitals of Paris, Paris, France. 13. Division of Surgical Oncology, Gustave Roussy Cancer Center and Paris-Sud University, Villejuif Cedex, Paris, France. 14. Department of Pathology, Necker-Enfants Malades Hospital, Public Assistance-Hospitals of Paris, Paris, France. 15. Department of Pediatric Hematology, Trousseau Hospital, Public Assistance-Hospitals of Paris, Sorbonne University, Paris, France. 16. CANPEDIF (CANcer PEDiatrie Ile-de-France), Gustave Roussy, Université Paris-Saclay, Villejuif, France. 17. Pediatric Radiology, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Neurodiderot, Paris, France. 18. Pediatric Ear, Nose, and Throat Department, Robert Debré Hospital, Public Assistance-Hospitals of Paris, Paris, France.
Abstract
INTRODUCTION: Cancer treatment in France is based on Multidisciplinary Tumor Board (MTB). In the Ile-de-France region (IDF), which includes 12 million inhabitants from Paris and the surrounding area, pediatric tumors of head and neck are discussed since 2013 in a dedicated Interregional Pediatric Multicentric MTB (IPMTB). The purpose of this study is to analyze the impact of the IDF head and neck IPMTB on the management of these tumors, 5 years after their implementation. MATERIALS AND METHODS: Retrospective study of all patient files presented in the IPMTB for a benign or malignant head-and-neck tumor, between 2013 and 2018. RESULTS: A total of 679 discussions were analyzed representing 428 patients. Median age was 7.5 years (range: 0-31 years). Malignant tumors represented 71% of cases, including 36% of rhabdomyosarcoma. Overall, 12% percent of the cases discussed came from centers outside of IDF. All meetings complied with multidisciplinary criteria required by French law. Proposals made during the IPMTB were followed in 86% of cases. Among the 251 proposals made by the referring teams prior to the IPMTB, 29% were secondarily modified after being discussed in the IPMTB. CONCLUSION: Thanks to their multidisciplinarity, high number of cases discussed and usual respect of their proposals, the IPMTB have made it possible to improve the coordination between all specialties involved in the patient's management, to apply the most recent and scientifically validated protocols, and to share the knowledge of different teams concerning the management of particularly rare tumors.
INTRODUCTION: Cancer treatment in France is based on Multidisciplinary Tumor Board (MTB). In the Ile-de-France region (IDF), which includes 12 million inhabitants from Paris and the surrounding area, pediatric tumors of head and neck are discussed since 2013 in a dedicated Interregional Pediatric Multicentric MTB (IPMTB). The purpose of this study is to analyze the impact of the IDF head and neck IPMTB on the management of these tumors, 5 years after their implementation. MATERIALS AND METHODS: Retrospective study of all patient files presented in the IPMTB for a benign or malignant head-and-neck tumor, between 2013 and 2018. RESULTS: A total of 679 discussions were analyzed representing 428 patients. Median age was 7.5 years (range: 0-31 years). Malignant tumors represented 71% of cases, including 36% of rhabdomyosarcoma. Overall, 12% percent of the cases discussed came from centers outside of IDF. All meetings complied with multidisciplinary criteria required by French law. Proposals made during the IPMTB were followed in 86% of cases. Among the 251 proposals made by the referring teams prior to the IPMTB, 29% were secondarily modified after being discussed in the IPMTB. CONCLUSION: Thanks to their multidisciplinarity, high number of cases discussed and usual respect of their proposals, the IPMTB have made it possible to improve the coordination between all specialties involved in the patient's management, to apply the most recent and scientifically validated protocols, and to share the knowledge of different teams concerning the management of particularly rare tumors.