ABSTRACT
For the last 90 years (much later in Poland) the Tumor Board (TUB) provide a forum to discuss about individual cases of patients with malignancy. This global institution has not fully met the challenges, especially in recent years. Deviations in TUB and delay in therapeutic interventions is an increasing problem in the pandemic. Much less attention is paid to worse diagnostics, i.e. a comprehensive assessment of all diseases and general condition. This favors treatment only in lifethreatening situations (mild cases are delayed), and thus palliative treatment dominates over radical one. An additional problem is the significant deviation between TUB, which was noticed in large university centers, such as for the hospital in Bonn, published in 2018. AIM: The aim of the study was to perform a retrospective analysis of 942 patients' history included 100 patients, who were covered at various stages by the decisions of TUB. MATERIALS AND METHODS: Following the German study, the present paper shows significant deviations in TUB decision, where the co-morbidity (including AIDS, tuberculosis or COVID-19) cause the failure of the treatment of the underlying disease. The retrospective analysis especially included patients with two proliferative processes: endogenous (mutant clone / host clones) and exogenous/xenogenic (microbes). RESULTS: 100 patients with complete history were enrolled in the study, six of whom were selected with survival-relevant deviations in the TUB decisions. The main issues were poor or late diagnosis of a chronic disease, the lack of proper grading and differentiation of symptoms, and thus distinguishing the most life-threatening process. CONCLUSIONS: Infection with SARS-CoV-2, AIDS or even tuberculosis, or the second neoplasm cannot be analyzed in a superficial way and thus be an excuse for disqualification from cancer treatment. On the other hand, as in the German study, the most important causes of deviations were patient expectations, death, comorbidities or treatment side effects. It is a significant shortcoming that in a significant proportion of patients, prior to the initiation of treatment (oncological or antimicrobial, e.g. HAART), insufficient diagnostic procedures was performed to establish the leading pathophysiological process.