Olaf Schoffer1, Martin Roessler2, Thomas Datzmann1, Dimosthenis Andreou3, Jens Jakob4, Martin Eichler5, Stephan Richter6, Markus K Schuler6,7, Jochen Schmitt1. 1. Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Dresden, Germany. 2. Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Dresden, Germany, martin.roessler@uniklinikum-dresden.de. 3. Abteilung für Tumororthopädie und Sarkomchirurgie, Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, Bad Saarow, Germany. 4. Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Georg-August-Universität, Universitätsmedizin Göttingen, Göttingen, Germany. 5. Nationales Centrum für Tumorerkrankungen Dresden (NCT/UCC), Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany. 6. Medizinische Klinik I, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany. 7. Klinik für Onkologie, HELIOS Klinikum Emil von Behring, Berlin, Germany.
Abstract
INTRODUCTION: Medical care of soft-tissue sarcoma (STS) and bone sarcoma (BS) patients in Germany has rarely been investigated. The objectives of this article were (1) to investigate medical care and survival in STS and BS patients, and (2) to examine methodological aspects of corresponding analyses based on administrative healthcare data. METHODS: We analyzed data from a statutory health insurance located in Saxony, Germany, covering approximately 2 million individuals. We identified incident STS and BS patients in the period 2012-2016 using 4 different case definitions. We examined treatment rates and visits to medical oncologists and medical practices descriptively, and then compared results between case definitions. We investigated survival prospects using a relative survival analysis and estimated hazard ratios (HRs) for risk factors for mortality using Cox regression. RESULTS: Across case definitions, the number of included sarcoma patients (STS: n = 871-1,757; BS: n = 216-689) and applied treatments (STS: 42.2-83.1%; BS: 28.3-77.8%) varied substantially. Irrespective of the case definition, the minority of patients visited medical oncologists (STS: 9.8-10.8% BS: 4.4-7.9%) and "experienced" medical practices (STS: 27.7-38.4%; BS: 18.3-23.6%). Survival prospects were better for patients who visited "experienced" medical practices (STS: HR = 0.55; BS: HR = 0.42). CONCLUSION: Treatment rates clearly <100% and evidence from survival analyses indicate the potential for improvements in the care of sarcoma patients in Germany, e.g., by physicians in "experienced" medical practices.
INTRODUCTION: Medical care of soft-tissue sarcoma (STS) and bone sarcoma (BS) patients in Germany has rarely been investigated. The objectives of this article were (1) to investigate medical care and survival in STS and BS patients, and (2) to examine methodological aspects of corresponding analyses based on administrative healthcare data. METHODS: We analyzed data from a statutory health insurance located in Saxony, Germany, covering approximately 2 million individuals. We identified incident STS and BS patients in the period 2012-2016 using 4 different case definitions. We examined treatment rates and visits to medical oncologists and medical practices descriptively, and then compared results between case definitions. We investigated survival prospects using a relative survival analysis and estimated hazard ratios (HRs) for risk factors for mortality using Cox regression. RESULTS: Across case definitions, the number of included sarcomapatients (STS: n = 871-1,757; BS: n = 216-689) and applied treatments (STS: 42.2-83.1%; BS: 28.3-77.8%) varied substantially. Irrespective of the case definition, the minority of patients visited medical oncologists (STS: 9.8-10.8% BS: 4.4-7.9%) and "experienced" medical practices (STS: 27.7-38.4%; BS: 18.3-23.6%). Survival prospects were better for patients who visited "experienced" medical practices (STS: HR = 0.55; BS: HR = 0.42). CONCLUSION: Treatment rates clearly <100% and evidence from survival analyses indicate the potential for improvements in the care of sarcomapatients in Germany, e.g., by physicians in "experienced" medical practices.
Authors: Martin Eichler; Dimosthenis Andreou; Henriette Golcher; Leopold Hentschel; Stephan Richter; Peter Hohenberger; Bernd Kasper; Daniel Pink; Jens Jakob; Hany Ashmawy; Simone Hettmer; Armin Tuchscherer; Matthias Grube; Vitali Heidt; Christina Jentsch; Jessica Pablik; Eva Wardelmann; Karl-Friedrich Kreitner; Ulrich Kneser; Carolin Tonus; Pauline Wimberger; Olaf Schoffer; Peter Reichardt; Markus Wartenberg; Maria Eberlein-Gonska; Martin Bornhäuser; Jochen Schmitt; Markus K Schuler Journal: Oncol Res Treat Date: 2021-04-22 Impact factor: 2.825