301. DIFFERENCES IN MULTIDISCIPLINARY CANCER CONFERENCES OF ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTIONAL CANCER REGARDING STAGING AND TREATMENT ALLOCATION—A MULTICENTER STUDY

Background There are differences in esophageal cancer care across different regions in Sweden. According to Swedish national guidelines, all patients diagnosed with these tumors should be individually evaluated by regional multidisciplinary cancer conferences (MCCs) to be recommended the best possible treatment. The aim of the study was to investigate differences between the regional MCCs in Sweden regarding clinical staging and recommended treatment. Method Representatives for all six regional MCCs were invited to contribute with ten retrospective consecutive cases each. After anonymization radiological investigations were presented, along with the original case-specific medical history, anew at all participating regional MCCs. Each MCCs’ clinical Tumor Nodal Metastasis classification (cTNM) and treatment recommendation (curative, palliative or best supportive care) were compared between MCCs as well as with the original assessment. Results Five regional MCCs joined the study. Out of 50 available cases the majority were assessed anew in addition to the previous original assessment. There was not consensus among the regional MCCs regarding clinical T-stage in 42 cases (84%), clinical N-stage in 33 cases (66%), and for clinical M-stage in 16 cases (32%). In 37 cases (74%) a positron emission tomography-computed tomography (PET-CT) was available. Differences in appraisal of cTNM were not associated with PET-CT availability. The MCCs agreed on treatment recommendations in 26/50 cases (52%). Discussion The study shows differences, both in assessment of cTNM as well as treatment recommendations at different MCCs. A patient recommended curative treatment by one MCC could be suggested palliative care by another. To achieve more equal care for esophageal cancer patients in Sweden it is essential to increase consensus on cTNM and recommended treatment.