Multidisciplinary Tumor Board Note

Multidisciplinary Tumor Board Note

Conference Date and Time: [Date and time]

Conference Type: [disease-site tumor board / molecular tumor board / general / other]

Location/Modality: [in-person / virtual / hybrid]

Patient Name: [Patient full name]

MRN: [MRN]

DOB: [DOB]

Presenting Clinician: [Name, credentials, service]

Moderator/Chair: [Name, credentials]

Documenter: [Name, credentials] (Include only if different from author)

Disciplines Present

(List attendees grouped by discipline with credentials. Document "Not present" for absent core disciplines rather than omitting.)

• Surgery: [Attendees with credentials / Not present]
• Medical Oncology: [Attendees with credentials / Not present]
• Radiation Oncology: [Attendees with credentials / Not present]
• Radiology: [Attendees with credentials / Not present]
• Pathology: [Attendees with credentials / Not present]

(Include additional disciplines only when present: genetics/genetic counseling, interventional radiology, palliative care, nursing/navigation, clinical trials/research, other.)

Consent and Disclaimer

Consent status: [patient consented / consent not required per policy / consent status unknown with follow-up planned]

Tumor board review is consultative; recommendations are advisory. Final management decisions should be made by the treating clinician in shared decision-making with the patient, incorporating patient preferences, comorbidities, and evolving clinical information.

Reason for Presentation

Category: [new diagnosis / post-operative planning / recurrence or progression / pathology clarification / imaging clarification / molecular interpretation / clinical trial eligibility / second opinion / other]

Clinical question(s): [Specific question(s) posed to the board]

Case Summary

Diagnosis: [Primary site, histology, key biomarkers, date of diagnosis]

Clinical course: [Concise timeline of prior surgeries, systemic therapy lines, radiation, and recurrences/progression]

Current status: [Performance status with scale, symptoms affecting function, major comorbidities impacting treatment feasibility]

Key labs: [Lab name, value, and date] (Include only if materially affects treatment options; otherwise omit this line)

Diagnostic Review

(Summarize only decision-relevant findings discussed at tumor board; do not copy full reports. Omit subsections that were not reviewed.)

Imaging Reviewed

• [Modality, body region, date] — [Key findings relevant to tumor extent, nodal status, metastatic disease, response assessment, or resectability]

(If studies are pending or unavailable, specify which and note that recommendations are contingent on results.)

Pathology Reviewed

• Specimen: [Specimen type, site, collection date]
• Findings: [Histology, grade, key staging elements including margins, nodes, depth/size, lymphovascular/perineural invasion as applicable]
• Biomarkers/Special studies: [Markers, results, method, date]

(If pathology is pending or unavailable, specify and note contingency.)

Molecular/Genetics Reviewed

(Include only if molecular or genomic testing was discussed at tumor board.)

• Test: [Test type, laboratory, specimen date]
• Key alterations: [Gene/alteration — pathogenic / likely pathogenic / VUS / benign]
• Actionability: [Therapeutic relevance, trial eligibility, resistance markers]
• Germline considerations: [Indications for germline testing or counseling, if discussed]

(If results are pending, note that recommendations are contingent.)

Staging

Staging system: [System and version, e.g., AJCC 8th edition]

Clinical stage: [cT, cN, cM; Stage group] — Basis: [imaging only / pathology confirmed / mixed]

Pathologic stage: [pT, pN, pM; Stage group] (Include only if surgical pathology available)

Stage status: [Complete / Pending — specify missing inputs required] (Do not infer a stage if key elements are missing; document what is needed to complete staging.)

Guideline-Based Options Reviewed

Guidelines referenced: [Name and version/date]

• Surgery: [Standard-of-care options relevant to patient's stage and fitness; key eligibility considerations]
• Radiation: [Standard-of-care options, intent, key eligibility or contraindications]
• Systemic therapy: [Intent, regimen class, molecular prerequisites, organ function and performance status requirements, prior therapy and resistance considerations]
• Clinical trials: [Yes, trials considered / No, not discussed / Not applicable — with rationale]
• Genetic counseling/testing: [Discussed and recommendation / Not indicated — with rationale]
• Supportive care: [Services discussed: palliative care, pain, nutrition, rehabilitation, psychosocial support, fertility preservation, smoking cessation]

(If no guideline-based deliberation occurred, document the reason.)

Discussion Summary

(Include for complex cases or when there was significant deliberation or disagreement. Summarize decision logic, trade-offs discussed, and resolution of disagreements. If material dissent exists, document majority view and minority view with core reasoning. Omit this section for straightforward cases.)

[Discussion summary]

Consensus Recommendations

Overall Recommendation: [1–2 sentence summary of recommended management strategy]

Plan

• Additional Diagnostic Workup: [Action/test; condition/trigger if contingent; responsible service; timeframe]
• Local Therapy: [Surgery and/or radiation intent, modality, sequencing; responsible service; timeframe]
• Systemic Therapy: [Intent, regimen class, timing; responsible service; timeframe]
• Clinical Trials: [Screening or referral action, trial name if specified; responsible service; timeframe]
• Genetics: [Referral or testing recommendation; responsible service; timeframe]
• Supportive Care: [Symptom management or specialty referral; responsible service; timeframe]

(Include only applicable plan domains. Document if/then contingencies for pending results. If consensus was not reached, document majority recommendation, minority recommendation with reasoning, and plan for resolution.)

Communication and Follow-Up

• Patient communication: [Who will communicate recommendations to patient and when]
• Referring clinician/PCP: [Who will communicate and timeframe]
• Implementation: [Service/clinician responsible for placing orders and coordinating care]
• Re-presentation: [Timing and conditions for re-presentation at tumor board] (Include only if applicable)

Signature

Author: [Name, credentials]

Date/Time: [Timestamp]