Wöckel Achim, Varga Dominic, Atassi Ziad, Kurzeder Christian, Wolters Regine, Wischnewsky Manfred, Wulff Christine, Kreienberg Rolf
Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany.
Onkologie. 2010;33(1-2):21-8. doi: 10.1159/000264617. Epub 2010 Jan 22.
To date, few studies have investigated whether the implementation of national breast cancer guidelines fulfills the goal to optimize the national standard of care. Therefore, we aimed to evaluate retrospectively the guideline-related 13-year data on breast cancer patients treated at our institution.
In a retrospective cohort study, the records of a total of 2,231 patients with primary breast cancer treated during the period of 1992-2005 at the Department of Obstetrics and Gynecology, University of Ulm, Germany, were analyzed. Based on the German national Step 3 (S3) guideline, a model was created to classify groups according to therapy 'conforming' and 'non-conforming' to guideline recommendations.
In 2005, 70.2% of all patients included received both surgical and systemic adjuvant therapies conforming to the guideline. Guideline-conforming treatment was accompanied with significant advantages in terms of recurrence-free survival (RFS) and overall survival (OAS) rates.
It has to be demanded that breast cancer patients are treated in conformity with the S3 guidelines. The reasons for a treatment not conforming to the guidelines should be analyzed for the detection of barrier factors, in order to optimize adherence to the guidelines and therefore to prolong RFS and OAS.
迄今为止，很少有研究调查国家乳腺癌指南的实施是否实现了优化国家标准治疗的目标。因此，我们旨在回顾性评估在我们机构接受治疗的乳腺癌患者的13年指南相关数据。
在一项回顾性队列研究中，分析了1992年至2005年期间在德国乌尔姆大学妇产科接受治疗的总共2231例原发性乳腺癌患者的记录。基于德国国家第三步（S3）指南，创建了一个模型，根据治疗是否“符合”和“不符合”指南建议对患者进行分组。
2005年，所有纳入患者中有70.2%接受了符合指南的手术和全身辅助治疗。符合指南的治疗在无复发生存率（RFS）和总生存率（OAS）方面具有显著优势。
必须要求按照S3指南对乳腺癌患者进行治疗。应分析不符合指南治疗的原因，以发现阻碍因素，从而优化对指南的遵循，进而延长无复发生存期和总生存期。
