Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Dresden, Germany.
Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Universitätsklinikum und Medizinische Fakultät Carl Gustav Carus an der TU Dresden, Dresden, Germany,
Oncol Res Treat. 2021;44(3):103-110. doi: 10.1159/000513178. Epub 2020 Dec 30.
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.
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.
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).
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.
德国软组织肉瘤（STS）和骨肉瘤（BS）患者的医疗护理很少被研究。本文的目的是（1）调查 STS 和 BS 患者的医疗护理和生存情况，（2）检查基于行政医疗保健数据的相应分析的方法学方面。
我们分析了德国萨克森州一家法定健康保险公司的数据，该保险覆盖了大约 200 万人。我们使用了 4 种不同的病例定义，在 2012 年至 2016 年期间确定了 STS 和 BS 的新发病例。我们对治疗率和就诊于肿瘤内科医生和医疗实践的情况进行了描述性分析，然后比较了不同病例定义的结果。我们使用相对生存分析来研究生存前景，并使用 Cox 回归来估计死亡风险的危险因素的危险比（HRs）。
在不同的病例定义下，纳入的肉瘤患者数量（STS：n = 871-1,757；BS：n = 216-689）和应用的治疗方法（STS：42.2-83.1%；BS：28.3-77.8%）差异很大。无论病例定义如何，只有少数患者就诊于肿瘤内科医生（STS：9.8-10.8%；BS：4.4-7.9%）和“经验丰富”的医疗实践（STS：27.7-38.4%；BS：18.3-23.6%）。就诊于“经验丰富”医疗实践的患者的生存前景更好（STS：HR = 0.55；BS：HR = 0.42）。
治疗率明显<100%，生存分析的证据表明，德国肉瘤患者的护理可能需要改进，例如，经验丰富的医疗实践中的医生可以提供更好的治疗。
