Breaking Barriers: The Impact of Telemedicine on Improving Soft Tissue and Bone Tumor Management in Armenia

• Published in: Journal of cancer policy 2024-12, Vol.43, p.100530, Article 100530
• Main Authors: Papyan, Ruzanna, Hovsepyan, Shushan, Hoveyan, Julieta, Hovhannisyan, Saten, Arakelyan, Tatev, Tamamyan, Gevorg, Sargsyan, Lilit, Hakobyan, Lusine, Davtyan, Levon, Lazaryan, Armine, Dallakyan, Davit, Manukyan, Narek, Mkhitaryan, Armen, Grigoryan, Nelli, Perkowski, Sybille, Froehlich, Birgit, Groll, Andreas, Schiborr, Manfred, Glutig, Katja, Kroeger, Kai, Deventer, Niklas, Vaal, Marieke Mathilda, Wiebe, Karsten, Haier, Joerg, Hartmann, Wolfgang, Wardelmann, Eva, Scheer, Monika, Jürgens, Heribert
• Format: Article
• Language: English
• Subjects: bone sarcoma; low-resource setting; remote healthcare; Soft Tissue Sarcoma; Telemedicine
• ISSN: 2213-5383; 2213-5383
• DOI: 10.1016/j.jcpo.2024.100530

Musculoskeletal sarcomas are a rare group of malignant neoplasms, accounting for approximately 12% of all malignant neoplasms among children. Childhood cancer outcomes vary between developed and developing countries due to financial and educational inequalities. Telemedicine programs have a huge impact on the quality of cancer care, helping to optimize resources for better cancer care in a resource-limited setting. In 2019, Armenia established multidisciplinary teams (MDT) with the guidance of international experts via telemedicine, significantly improving patients’ management diagnosed with sarcomas. The musculoskeletal cancer working group, mentored by the University Hospital of Münster (UKM), conducted weekly virtual tumor boards to discuss cases, focusing on the review of pathological and radiological examinations. Results: From August 2019 to December 2023, the musculoskeletal cancer MDT discussed 151 musculoskeletal tumor cases via 74 MDT meetings. Imaging studies of all discussed cases were reviewed, while the review of histology images was performed for 93% of cases. The pathology review led to changes in previously established diagnoses in eleven cases, which subsequently changed management. These led to altered local control strategies for 32 patients, with 5 requiring treatment abroad, and changes in chemotherapy regimens for 17 patients. Notably, there were no cases of treatment refusal post-implementation, a reduction from the previous 3% refusal rate. The successful telemedicine initiative, coupled with institutional support, improved the care of patients diagnosed with musculoskeletal tumors. The investment in telemedicine in developing countries not only enhances communications with international and local experts across various disciplines but also significantly improves the handling of patients diagnosed with sarcomas. •Sarcomas, though uncommon, represent 12% of malignant tumors in children, with survival rates varying globally.•Telemedicine offers a cost-effective and efficient approach to managing sarcomas in children and adolescents and young adults (AYAs) in resource limited setting.•Weekly virtual tumor boards held at Pediatric Cancer and Blood Disorders Center of Armenia led to diagnostic changes in 30.6% of cases.•Local control strategies were altered for 38% of patient’s post-discussion.