Effect of outside referrals to a tertiary care liver tumor board on diagnostic testing and initial curative therapy.

259Background: Hepatocellular carcinoma (HCC) is a complex and unique cancer. Arriving at the optimal treatment plan is best accomplished by a multidisciplinary tumor board (MDTB). We hypothesized that patients referred from outside institutions to our tertiary care center for MDTB review may face disparities in diagnosis and treatment. Methods: We performed chart review of incident HCC cases presented from 2/1/13-2/1/16 at an American College of Surgeons accredited MDTB that convenes weekly at a tertiary care, university-affiliated hospital. We examined variables such as demographics, originating institution, liver disease etiology, location of index imaging, date of first tumor board presentation, diagnostic method (imaging, biopsy, tumor board consensus), BCLC stage at diagnosis, initial treatment, and time to treatment. Results: 167 cases of HCC were referred from 37 outside institutions (outside cases); 127 cases originated from our institution (internal cases). The two groups were comparable in gend...