Regional appendix cancer multidisciplinary case conference: Improving access and care of a rare disease.

63 Background: Appendiceal cancers (AC) are a group of rare tumors that lack well-established guidelines. Care for ACs need multi-disciplinary teams. Excellence in hyperthermic intraperitoneal chemotherapy (HIPEC) and complete cytoreductive surgeries (CRS) is needed. This is challenging in community settings. Here we share our experience in establishing a regional multidisciplinary case conference (MCC) to improve access and care of this rare disease. Methods: University of Chicago Medical Center's (UCMC) experts in pathology, radiology, nutrition, surgical oncology and medical oncology collaborated to form the peritoneal MCC. We consulted our legal and physician access teams to develop a compliant system through which referring providers may submit their cases including imaging, pathology and medical history. Referring providers attended the conference via a secure virtual platform. To bridge scientific collaborations we created a continuous medical education (CME)-based curriculum. With UCMC survey lab’s help, we developed and distributed an anonymous digital survey to assess the impact of this MCC. Results: The peritoneal MCC was established in May of 2020 with consistent participation of surgical oncology experts in HIPEC and peritoneal disease management, medical oncology, radiology, pathology, and gastroenterology with expertise in nutrition. Cases were referred internally and from our regional network. Between May 2020 and June 2022, 614 unique clinical cases were discussed. Our team invited 37 referring providers to join this conference. From February 1 st 2021 to June 2022, more than 40 different educational lectures were presented. There were 30 respondents to the survey where the majority were from UCMC. Of those who were non-UCMC (n=8), 62.5% practiced in urban setting and 7.5% in suburban, rural or small-town setting. 62.5% of non-UCMC respondents were community-based providers, and 37.5% worked at academic centers. 45.8% of providers attending had more than 5 years of experience. 100% of the respondents reported improved confidence in treating their patients as a result of participation in this conference. 94.1% reported at least moderate improvement in the quality of their care. 93.3% of the respondents noted that the care plan of their patients changed as a result of participation in this MCC. Conclusions: Virtual MCC was feasible and reported to be beneficial in management of a rare disease like AC. Such conferences can lead to improvement in the quality of care by improving access to centers with expertise. Participating providers gain knowledge and feel more confident in taking care of their patients. In future, we aim to include more centers. Consideration on how to include patients may also prove beneficial.