Endometrial Cancer - Long-Term Survival in Certified Cancer Centers and Non-Certified Hospitals: Comparative Analysis Based on a Large German Retrospective Cohort Study (WiZen)

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Judith Hansinger - , Bavarian Center for Cancer Research (BZKF) (Author)
  • Vinzenz Völkel - , Bavarian Center for Cancer Research (BZKF) (Author)
  • Michael Gerken - , Bavarian Health and Food Safety Authority (LGL) (Author)
  • Olaf Schoffer - , Center for Evidence-Based Healthcare, Center for Evidence-Based Healthcare (Author)
  • Pauline Wimberger - , Department of Gynecology and Obstetrics, National Center for Tumor Diseases (NCT) Dresden, Clinic and Polyclinic for Gynecology and Obstetrics (Author)
  • Veronika Bierbaum - , Center for Evidence-Based Healthcare, Center for Evidence-Based Healthcare (Author)
  • Christoph Bobeth - , Center for Evidence-Based Healthcare, Center for Evidence-Based Healthcare (Author)
  • Martin Rößler - , Center for Evidence-Based Healthcare, Center for Evidence-Based Healthcare (Author)
  • Patrik Dröge - , Allgemeine Ortskrankenkasse (AOK), Research Institute Berlin (Author)
  • Thomas Ruhnke - , Allgemeine Ortskrankenkasse (AOK), Research Institute Berlin (Author)
  • Christian Günster - , Allgemeine Ortskrankenkasse (AOK), Research Institute Berlin (Author)
  • Kees Kleihues-van Tol - , Association of German Tumor Centers (Author)
  • Theresa Link - , Department of Gynecology and Obstetrics, National Center for Tumor Diseases (NCT) Dresden, Clinic and Polyclinic for Gynecology and Obstetrics (Author)
  • Karin Kast - , University of Cologne (Author)
  • Thomas Papathemelis - , Klinikum St. Marien Amberg (Author)
  • Olaf Ortmann - , University of Regensburg, Caritas Hospital St. Josef Regensburg (Author)
  • Jochen Schmitt - , Center for Evidence-Based Healthcare, Center for Evidence-Based Healthcare (Author)
  • Monika Klinkhammer-Schalke - , Association of German Tumor Centers (Author)

Abstract

Introduction Endometrial cancer is the most common malignant tumor of the female genital organs. In Germany, treatment is provided in both cancer centers certified by the German Cancer Society (Deutsche Krebsgesellschaft, DKG) and in non-certified hospitals. This study investigated whether treatment in DKG-certified centers leads to improved overall survival of patients with endometrial cancer. Materials and Methods Data from 11 legally independent German statutory health insurance (SHI) funds of the AOK were analyzed as well as data from four clinical cancer registries (CCR), resulting in inclusion of 30 102 AOK patients and 8190 registry patients with a diagnosis (incidental cases) of ICD-10-GM code C54 (malignant neoplasm of corpus uteri). For comparative survival analyses, multivariable Cox regressions and Kaplan-Meier analyses were used. Results The Kaplan-Meier estimator for 5-year overall survival was 66.7% for patients from certified centers and 65.0% for patients from non-certified hospitals (using SHI data; CCR data: 63.4% vs. 60.7%). Cox regression adjusted for relevant confounders showed a hazard ratio (HR) of 0.93 (SHI data; 95% CI 0.86 - 1.00; p = 0.050) and 0.935 (CCR data; 95% CI 0.827 - 1.057; p = 0.281) for all-cause mortality. In a subgroup analysis (CCR), patients with International Union against Cancer Control (UICC) stage I had a significant survival benefit if treated in a certified center (HR 0.783; 95% CI 0.620 - 0.987; p = 0.038). Conclusion The study presented herein shows that patients with endometrial cancer treated in a certified cancer center tend to have better survival rates. This should be considered when selecting the treating hospital.

Details

Original languageEnglish
Pages (from-to)979-988
Number of pages10
JournalGeburtshilfe und Frauenheilkunde
Volume84
Issue number10
Publication statusPublished - Oct 2024
Peer-reviewedYes

External IDs

PubMedCentral PMC11444750
ORCID /0000-0001-6922-7148/work/173517071
unpaywall 10.1055/a-1869-2060

Keywords

Sustainable Development Goals