Multidisciplinary Tumor Board Note (Pediatric Oncology)

Tumor Board: [Name, e.g., Pediatric Solid Tumor Board, Pediatric Neuro-Oncology MTB]

Date: [YYYY-MM-DD]   Time: [Start – End]

Location/Format: [in-person / virtual / hybrid]; [location or platform]

Author: [Name and role]

Participants

(List disciplines and names of contributors who actively participated in decision-making. Include role when relevant. Add or remove lines as needed.)

• Radiology: [Name(s) — role]
• Pathology: [Name(s) — role]
• Pediatric Hematology/Oncology: [Name(s) — role]
• Surgery: [Name(s) — role]
• Radiation Oncology: [Name(s) — role]
• Other: [Discipline — Name(s) — role]

Reason for Presentation

• Category: [new diagnosis / post-operative pathology review / staging confirmation / response assessment / relapse or progression / molecular result interpretation / complex toxicity or feasibility discussion]
• Clinical question(s): [Specific question to be addressed]

Brief Case Summary

(Provide only context needed to interpret staging and choose therapy. Omit routine family history, full ROS, and comprehensive medication lists unless directly relevant.)

• Patient age: [Age in years or months]
• Relevant baseline conditions: [cardiac / renal / hepatic / immunodeficiency / prior transplant / significant syndromes / none] (Include only if affecting therapy)
• Oncologic timeline: [Initial presentation and date]; [biopsy/resection date(s)]; [prior therapies and response or "Not available at time of tumor board"]
• Current disease status: [Summary of current burden and sites]
• Performance status: [Scale and score if documented / Not documented]

Pathology

(Summarize findings that anchor diagnosis and inform staging. Reference accession numbers; do not paste full reports.)

• Specimens reviewed: [biopsy / resection / bone marrow / CSF / other]; [collection date(s)]; [accession #]; [internal / external / both]
• Integrated diagnosis: [Site] — [histologic and/or molecular classification]; [grade if relevant]; [margin status]; [lymph node status]; [tumor necrosis or treatment effect if relevant]
• Key markers supporting diagnosis/subtype: [IHC / flow / cytogenetic markers limited to diagnostic, prognostic, or targetable findings]
• Status: [definitive / provisional — if provisional, state confirmatory studies pending and expected timeline]

Molecular / Genomics

(Include when molecular data were reviewed or testing is recommended. Clearly separate laboratory-reported findings from tumor board interpretation.)

• Assay and lab: [Assay name/type]; [specimen source]; [report date]; [performing lab]
• Laboratory-reported key findings: [Driver alterations / fusions / copy-number changes / biomarkers with variant details and reported significance] (Include VUS only if specifically discussed)
• Tumor board interpretation: [Clinical significance — diagnostic / prognostic / therapeutic]; [recommended action]; [assay limitations if relevant]
• Germline testing: [recommended / ordered / resulted / not indicated]; [genetic counseling referral status]

(If no molecular testing reviewed, state "No molecular testing reviewed" and list any recommended tests.)

Imaging

• Studies reviewed: [Modality and region]; [date]; [images reviewed directly / report-only]; [outside / internal]
• Key findings:
  • Primary tumor: [Size/extent]; [involvement of critical structures]
  • Nodal disease: [Location and criteria used]
  • Metastatic sites: [Locations with supporting evidence and measurements]
• Response assessment: [Method used]; [comparison baseline date]; [response category] (Include if applicable)
• Discrepancy with original report: [None / describe discrepancy and whether addendum or second read requested]

Other Key Diagnostics

(Include only results that change stage, risk, or therapy selection. Omit section if not applicable.)

• Bone marrow: [Date]; [result]
• CSF cytology/flow: [Date]; [result]
• Tumor markers: [Marker]; [value and date]
• Organ function constraints: [Cardiac / renal / hepatic / pulmonary]; [key values and dates]

Consensus Stage / Risk

• Staging system: [Tumor-type specific system name]
• Basis: [clinical / pathologic / post-therapy]
• Assigned stage: [Stage] (If uncertain, state "Provisional" and reason)
• Risk group: [Risk category]; [features driving risk: metastatic status / histology / molecular markers / response category]
• Re-discussion planned: [Date or trigger / not needed]

Consensus Recommendations

(Organize by problem when multiple issues were addressed. Convert vague recommendations into actionable statements.)

[Problem 1]: [Diagnosis or key issue]

• Goal of therapy: [curative / disease control / palliative]
• Recommended protocol/regimen: [Protocol/regimen name]; [COG or cooperative group alignment if applicable]
• Planned modalities: [chemotherapy / surgery / radiation / transplant / supportive care]
• Rationale: [Concise reasoning, especially if deviating from typical pathways]
• Immediate next step: [Action]; [time sensitivity]
• Contingency plans: [If X, then Y] (Include if discussed)
• Clinical trials: [Eligibility discussion]; [screening referral]; [tissue requirements] (Include if discussed)
• Fertility preservation: [Discussed and referred / not applicable] (Include if discussed)

[Problem 2]: [Additional issue]

• Plan: [Actionable recommendation with owner and timing]

(Add additional problem sections as needed.)

Action Items

(If no action items exist, state "No new action items; continue current plan.")

• [Owner/service]: [Task] — [Due date or timeframe]; [Dependencies if any]
• [Owner/service]: [Task] — [Due date or timeframe]; [Dependencies if any]

Communication / Follow-up

• Family informed: [yes / no / planned — if planned, specify who and by when]
• Patient/guardian preferences: [Brief note if relevant; include assent/consent considerations for pediatric patients]
• Disagreement during discussion: [None / summarize dissenting viewpoint and whether alternative will be discussed with family]
• Re-discussion plan: [Date or trigger / none needed]

(This note documents a multidisciplinary tumor board discussion, not a full H&P. Reference original report identifiers rather than pasting reports. Distinguish between reviewed source documents, tumor board interpretations, and recommendations. Use explicit labels such as "Pending" or "Not available" for missing information.)