1. Introduction
Southeast Asia has been the scene of substantial initiatives in
pediatric cancer resource development in recent years1-4. With a total population of 668 million, the
region is home to 8.5% of the global childhood population aged 14 and
under, with approximately 16,000 new cases of childhood cancer annually
and the 3rd highest rate of childhood cancer mortality
worldwide, after Western and North Africa 5-7.
Although 9 of the 11 countries that comprise the region are low- and
middle-income countries (LMICs) 8, advancements have
been achieved in treatment standards and outcomes in pediatric cancer,
yet significant gaps still remain particularly with respect to the care
of solid and brain tumors 9-16.
Solid tumor management requires the coordinated effort of teams of
multiple medical specialties, and varied infrastructural resources
ranging from surgical and radiation facilities to laboratory and
pathology services 17. Interestingly, while
availability of each of these elements may vary between centers, this
does not preclude delivery of effective curative treatment for pediatric
tumors when available resources can be appropriately channeled18,19. This underscores the importance of the
multidisciplinary tumor board (MDTB) as a critical element for advancing
pediatric solid tumor care, and one that remains relevant even in LMICs20-22. However, organizing MDTBs can be an
organizational burden and amounts to extra workload for the involved
personnel 23,24, especially in centers with
already-limited resources.
From a pilot survey of pediatric surgeons in Southeast Asia, we found
that not all centers in Southeast Asia that care for childhood tumor
patients had pediatric MDTBs, and in centers that had them, pediatric
oncologists and surgeons were the two specialists that were most
involved in these meetings. Hence, we conducted a cross-sectional survey
to profile MDTBs from pediatric oncology centers in LMIC countries
around Southeast Asia, and to study perceptions on benefits and barriers
for MDTBs among pediatric surgeons and pediatric oncologists.