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Published in: BMC Cancer 1/2022

Open Access 01-12-2022 | Pancreatic Cancer | Research

Is treatment in certified cancer centers related to better survival in patients with pancreatic cancer? Evidence from a large German cohort study

Authors: Martin Roessler, Jochen Schmitt, Christoph Bobeth, Michael Gerken, Kees Kleihues-van Tol, Christoph Reissfelder, Bettina M. Rau, Marius Distler, Pompiliu Piso, Christian Günster, Monika Klinkhammer-Schalke, Olaf Schoffer, Veronika Bierbaum

Published in: BMC Cancer | Issue 1/2022

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Abstract

Background

Treatment of cancer patients in certified cancer centers, that meet specific quality standards in term of structures and procedures of medical care, is a national treatment goal in Germany. However, convincing evidence that treatment in certified cancer centers is associated with better outcomes in patients with pancreatic cancer is still missing.

Methods

We used patient-specific information (demographic characteristics, diagnoses, treatments) from German statutory health insurance data covering the period 2009–2017 and hospital characteristics from the German Standardized Quality Reports. We investigated differences in survival between patients treated in hospitals with and without pancreatic cancer center certification by the German Cancer Society (GCS) using the Kaplan–Meier estimator and Cox regression with shared frailty.

Results

The final sample included 45,318 patients with pancreatic cancer treated in 1,051 hospitals (96 GCS-certified, 955 not GCS-certified). 5,426 (12.0%) of the patients were treated in GCS-certified pancreatic cancer centers. Patients treated in certified and non-certified hospitals had similar distributions of age, sex, and comorbidities. Median survival was 8.0 months in GCS-certified pancreatic cancer centers and 4.4 months in non-certified hospitals. Cox regression adjusting for multiple patient and hospital characteristics yielded a significantly lower hazard of long-term, all-cause mortality in patients treated in GCS-certified pancreatic centers (Hazard ratio = 0.89; 95%-CI = 0.85–0.93). This result remained robust in multiple sensitivity analyses, including stratified estimations for subgroups of patients and hospitals.

Conclusion

This robust observational evidence suggests that patients with pancreatic cancer benefit from treatment in a certified cancer center in terms of survival. Therefore, the certification of hospitals appears to be a powerful strategy to improve patient outcomes in pancreatic cancer care.

Trial registration

ClinicalTrials.gov (NCT04334239).
Appendix
Available only for authorised users
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Metadata
Title
Is treatment in certified cancer centers related to better survival in patients with pancreatic cancer? Evidence from a large German cohort study
Authors
Martin Roessler
Jochen Schmitt
Christoph Bobeth
Michael Gerken
Kees Kleihues-van Tol
Christoph Reissfelder
Bettina M. Rau
Marius Distler
Pompiliu Piso
Christian Günster
Monika Klinkhammer-Schalke
Olaf Schoffer
Veronika Bierbaum
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2022
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-022-09731-w

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