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Evaluating the German oncology certification system and its implications for colorectal carcinoma - a national and international comparison of relative survival rates.
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  • Maximilian Richter,
  • Lena Sonnow,
  • Amir Mehdizadeh-Shrifi,
  • Axel Richter,
  • Rainer Koch,
  • Alexander Zipprich
Maximilian Richter
Martin-Luther-Universität Halle-Wittenberg
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Lena Sonnow
Medizinische Hochschule Hannover
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Amir Mehdizadeh-Shrifi
Medizinische Hochschule Hannover
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Axel Richter
HELIOS Klinikum Hildesheim
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Rainer Koch
Technische Universität Dresden
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Alexander Zipprich
Martin-Luther-Universität Halle-Wittenberg
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Abstract

Rationale, aims and objectives In order to evaluate how the certification of specialised Oncology Centres in Germany affects the relative survival of patients with colorectal cancer (CRC), a national and international comparison was performed. Method Between 2007 and 2013, 675 patients with colorectal cancer treated at the Hildesheim Hospital, an academic teaching hospital of the Hanover Medical School (MHH), were included. A follow up of the entire patient group was performed until 2014. To obtain international data, a SEER-database search was done. The relative survival of 148,957 patients was compared to our data after 12, 36 and 60 months. For national survival data, we compared our rates with 36,048 patients of the Munich Cancer Registry (MCR) Results Relative survival at Certified Oncology Centres was significantly higher in advanced tumour stages compared with national and international cancer registry data. Nationally, we found only little variation in survival rates for low stage (UICC I, II) CRC, colon, and rectal carcinoma. Both colon and rectal carcinoma showed notable variations in their relative survival rates for advanced tumour stages. These variations were even more distinct for rectal carcinoma (Hildesheim Hospital: 89.9%, 40.3%, 30.1%; Munich Cancer Registry (MCR): 63.6%, 26.2%, 15.2%). The international comparison for colorectal cancer, colon cancer and rectal cancer showed significantly higher survival rates for patients with advanced tumour stages at the Certified Cancer Centre. CRC (UICC IV) at month 12 had a relative survival of 77% whereas the international survival was only 54,9% (raw p<0.001). Conclusion Our findings suggest that patients with advanced tumour stages of CRC and rectal cancer, benefit most from multidisciplinary treatment at Certified Oncology Centres as compared to low stage CRC and rectal carcinoma. However, the creation of unified national registry data bases is necessary for future evaluation of cancer treatment and improved international comparison.

Peer review status:POSTED

13 May 2020Submitted to Journal of Evaluation in Clinical Practice
20 May 2020Assigned to Editor
20 May 2020Submission Checks Completed