Purpose: Multidisciplinary meetings (MDM) provide a forum in which health care professionals can bring together their expertise from various disciplines to optimise patient care, and are commonly implemented for the management of genito-urinary cancers. Our objective was to analyze the impact of the Austin Health (AH) uro-oncology MDM on patient management decisions, an area in which there is a paucity of evidence.

Methods: From May 2012 to July 2012, all cases presented at the AH weekly uro-oncology MDM were prospectively assessed,by asking the presenting clinician to record their provisional management plans and comparing this with the subsequent consensus decision reached after discussion at the MDM. The impact of the MDM was graded as high if there was a major change in the management plan or if a plan was developed where there was none.

Results: Over the three-month study period, 120 discussions about 107 patients were recorded. Prostate, urothelial, kidney and testis cancer represented 46 (38.3%), 36 (30%), 26 (21.6%) and 12 (10%) of discussions respectively. The MDM made high impact changes to the original plan in 32 (26.7%) cases. High impact management changes were twice as likely to occur in patients with metastatic disease compared to those without (p<0.05). Primary cross referral between disciplines occurred in 40 (33.3%) cases, including 66.7% of testicular and 42% of bladder cancers but only 26% of prostate and 19% of kidney cancers (p<0.02).

Conclusions: The AH uro-oncology MDM alters management plans in approximately one quarter of cases, more so if metastatic disease is evident. However, MDMs also serve purposes other than decision-making, such as education, cross-referral, consideration for clinical trials and peer-review of clinical practice.