Impact of a comprehensive multidisciplinary tumor board program on treatment decision-making and patient compliance in a tertiary care hospital in Thailand.

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Background: Multidisciplinary Tumor Boards (MTBs) are integral to quality cancer care, promoting evidence-based treatment through collaborative decision-making. While benefits are well established in Western settings, data from Southeast Asian tertiary hospitals serving diverse patients remain limited. This study evaluates the impact of a comprehensive tumor board program at a private tertiary hospital in Bangkok, Thailand. Methods: A retrospective review was conducted of all cases discussed at institutional tumor boards from January 2021–December 2025. The program includes four boards: Multidisciplinary Tumor Boards (MDT), Molecular Tumor Boards (MTB), Bumrungrad Lung Cancer Consortium (BLCC), and Palliative Oncology Tumor Board (POTB). Data included patient demographics, cancer type, stage, board category, treatment recommendations, compliance, and reasons for non-compliance. Tumor board impact was classified as no change, assisted treatment decision, altered treatment, further diagnostic workup, or de novo treatment planning. Results: A total of 1,391 cases were reviewed over five years. The population comprised 55% international patients, 32% Thai nationals, and 13% expatriates. Major malignancies were lung (20.9%), breast (10.7%), colon (7.1%), hepatobiliary (6.2%), rectal (4.7%), prostate (4.2%), and pancreatic (4.2%) cancers, with over 60 cancer types represented. Most cases were stage IV (54.2%) or stage III (10.1%). Distribution by board: MDT 75.5%, MTB 18.2%, BLCC 3.6%, and POTB 2.7%. Annual utilization was consistent (212–313 cases/year). Among 171 evaluable cases, tumor board impact showed clinical significance—38.6% led to actionable changes: altered treatment (7.0%), aided decisions (14.0%), or required further diagnostics (17.0%); 0.6% were fully directed by board recommendations. No change was noted in 61.4%, validating prior management. Compliance with recommendations was high (87.1%). Among non-compliant cases (12.9%), main reasons were loss to follow-up (69.5%), treatment elsewhere (13.8%), management abroad (3.4%), and refusal of proposed treatment (6.3%). Conclusions: This 5-year analysis demonstrates that a structured tumor boards in a Southeast Asian tertiary setting enhance multidisciplinary decision-making, influencing management in nearly 40% of cases and achieving strong treatment compliance. Specialized tumor boards (molecular, lung consortium, palliative) complement general MDT functions, addressing complex genomic, disease-specific, and end-of-life care needs. Non-compliance was mainly patient related factor rather than disagreement with recommendations. These findings support the value of comprehensive MTBs in Southeast Asian tertiary care settings managing diverse cancer populations with high disease burden and rare cancers.