Large Language Models for Multidisciplinary Tumor Board Decision-Making in Primary Liver Tumors: A Retrospective Single-Center Study

Cancers, vol. 18, pp. 2175

Abstract

Introduction: Multidisciplinary tumor boards (MTBs) are the standard for oncologic decision-making but require substantial time and personnel resources. Large language models (LLMs) may support MTBs by generating structured, guideline-based recommendations. We evaluated concordance between MTB decisions and LLM recommendations in newly diagnosed cholangiocellular adenocarcinoma (CCA) and hepatocellular carcinoma (HCC). Method: In this retrospective single-center study, MTB protocols from 2022–2023 were screened. After exclusions, 50 CCA and 50 HCC cases were analyzed. Institutional MTB recommendations were compared with outputs from ChatGPT and Claude using identical structured clinical summaries available at the time of MTB presentation. Agreement was assessed using Cohen’s kappa, and correlation using Spearman’s rank coefficient. Results: For CCA, exact concordance between MTB and ChatGPT was 80%, with substantial agreement (k = 0.688) and strong correlation (r = 0.725; both p < 0.001). Concordance with Claude was at 56%. For HCC, concordance between MTB and ChatGPT was 66%, with substantial agreement (k = 0.604) and moderate correlation (r = 0.484; both p < 0.001). Concordance with Claude was only 38%, with fair agreement (k = 0.314, p < 0.001) and weak correlation (r = 0.086, p = 0.551). Conclusions: LLM-derived recommendations varied markedly by model. ChatGPT demonstrated substantial concordance, whereas Claude showed limited agreement. MTBs appeared more individualized, while LLM outputs were more guideline-oriented. These findings highlight the potential role of LLMs as supportive tools for structured clinical reasoning and guideline adherence. Prospective multicenter studies should evaluate real-time LLM integration into MTB workflows, efficiency, decision quality, and patient outcomes safely.

Authors 16

1. Julian Palzer corresponding Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

2. Alexander Genchev Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

3. Esref Belger Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

4. Clara Antonia Weigle Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

5. Bengt Arne Wiemann Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

6. Philipp Tessmer Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

7. Mohamad Murad Aachen Centrum for Integrated Oncology Department of Gastroenterology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of Gastroenterology, University Hospital RWTH Aachen, 52074 Aachen, Germany

8. Marie‐Luise Berres Aachen Centrum for Integrated Oncology Department of Gastroenterology

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of Gastroenterology, University Hospital RWTH Aachen, 52074 Aachen, Germany

9. F. Meister Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

   Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

10. Iakovos Amygdalos Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

11. Philipp Bruners Aachen Centrum for Integrated Oncology Department of Radiology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of Radiology, University Hospital RWTH Aachen, 52074 Aachen, Germany

12. Daniel Truhn Aachen Centrum for Integrated Oncology Department of Radiology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of Radiology, University Hospital RWTH Aachen, 52074 Aachen, Germany

13. Ahmed Allam Mohamed Aachen Centrum for Integrated Oncology Department of Radiation Oncology

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of Radiation Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

14. Florian Wolfgang Rudolf Vondran Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

15. Felix Oldhafer Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany

16. Oliver Beetz Aachen Centrum for Integrated Oncology Department of General, Visceral Pediatric and Transplant Surgery

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Centrum for Integrated Oncology, University Hospital RWTH Aachen, 52074 Aachen, Germany

    Department of General, Visceral, Pediatric and Transplant Surgery, University Hospital RWTH Aachen, 52074 Aachen, Germany