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.