Weikert S, Baumunk D, Stephan C, Cash H, Jahnke K, Steiner U, Werthemann P, Kempkensteffen C, Magheli A, Hinz S, Jagota A, Reichelt U, Busch J, Klopf C, Miller K, Schostak M
Klinik für Urologie, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
Urologe A. 2011 Sep;50(9):1083-8. doi: 10.1007/s00120-011-2629-0.
The introduction of prostate cancer treatment centers according to the criteria of the German Cancer Society ("Deutsche Krebsgesellschaft", DKG) aims at improving the quality of care for patients with prostate cancer. Systematic analyses of the effects and costs are lacking as yet. Three years after certification of the Interdisciplinary Prostate Cancer Center at the Charité Hospital Berlin we observed a decrease in the rate of positive surgical margins (tumor stage pT2), but other parameters of treatment quality including patient satisfaction remained unchanged. A survey among urologists of the region showed a high acceptance of prostate cancer centers in general. The majority of participating urologists appreciated the work of the Charité center, in particular the treatment recommendations given by the center were mostly followed and the majority of urologists regularly use educational activities of the center. However, only 30% of the participating urologists confirmed short-term improvements in the quality of patient care. Yearly additional costs for the Charité prostate cancer center are estimated at 205,000 euro (precertification phase and certification) and 138,000 euro (monitoring phase), despite the initial drop in mean treatment costs per case (radical prostatectomy). The introduction of prostate cancer treatment centers certified by the DKG is cost intensive, increases in treatment efficiency notwithstanding. Short-term improvements in quality of care cannot be unequivocally demonstrated. Prostate cancer centers serve an important role in counseling and medical education and may thus help disseminate evidence-based treatment strategies.
按照德国癌症协会（“Deutsche Krebsgesellschaft”，DKG）的标准引入前列腺癌治疗中心，旨在提高前列腺癌患者的护理质量。目前尚缺乏对其效果和成本的系统分析。柏林夏里特医院的跨学科前列腺癌中心获得认证三年后，我们观察到手术切缘阳性率（肿瘤分期pT2）有所下降，但包括患者满意度在内的其他治疗质量参数并未改变。该地区泌尿外科医生的一项调查显示，总体上对前列腺癌中心的接受度很高。大多数参与调查的泌尿外科医生赞赏夏里特中心的工作，特别是该中心给出的治疗建议大多得到遵循，并且大多数泌尿外科医生经常使用该中心的教育活动。然而，只有30%的参与调查的泌尿外科医生确认患者护理质量有短期改善。尽管最初每例病例（根治性前列腺切除术）的平均治疗成本有所下降，但夏里特前列腺癌中心每年的额外成本估计为20.5万欧元（认证前阶段和认证阶段）和13.8万欧元（监测阶段）。引入由DKG认证的前列腺癌治疗中心成本高昂，尽管提高了治疗效率。护理质量的短期改善无法得到明确证明。前列腺癌中心在咨询和医学教育方面发挥着重要作用，因此可能有助于传播基于证据的治疗策略。
