Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany.
National Center for Tumor Diseases (NCT/UCC), Dresden, Germany.
Oncol Res Treat. 2021;44(6):301-312. doi: 10.1159/000516262. Epub 2021 Apr 22.
Data on institutional structures of sarcoma care in Germany are scarce. The utilization of an interdisciplinary tumor board (IDTB) is an essential part of modern cancer care. We investigated to which extent and when IDTB are used in sarcoma care. We hypothesized that IDTB before treatment initiation were used more often at certified cancer centers and at high-volume centers and that IDTB utilization increased over time.
From 2017 to 2020 we conducted a prospective cohort study, undertaking major efforts to include the whole spectrum of sarcoma treatment facilities. To analyze potential predictors of IDTB utilization, we calculated multivariable logistic regressions.
Patients and survivors (n = 1,309) from 39 study centers (22 tertiary referral hospitals, 9 other hospitals, and 8 office-based practices) participated; 88.3% of the patients were discussed at some stage of their disease in an IDTB (56.1% before treatment, 78% after therapy, and 85.9% in metastatic disease). Hypotheses were confirmed regarding the utilization of IDTB in certified cancer centers (vs. all others: OR = 5.39; 95% CI 3.28-8.85) and the time of diagnosis (2018/2019 vs. until 2013: OR = 4.95; 95% CI 2.67-9.21).
Our study adds to the evidence regarding the institutional structures of sarcoma care in Germany. Utilization of a tumor board before therapy seems to be in an implementation process that is making progress but is far from complete. Certification is a possible tool to accelerate this development.
德国肉瘤治疗机构结构的数据稀缺。多学科肿瘤委员会（IDTB）的利用是现代癌症治疗的重要组成部分。我们调查了 IDTB 在肉瘤治疗中的使用程度和时间。我们假设在认证癌症中心和高容量中心，治疗前启动 IDTB 的使用更为频繁，并且 IDTB 的使用随着时间的推移而增加。
我们从 2017 年至 2020 年进行了一项前瞻性队列研究，为纳入肉瘤治疗设施的整个范围做出了重大努力。为了分析 IDTB 利用的潜在预测因素，我们计算了多变量逻辑回归。
39 个研究中心（22 家三级转诊医院、9 家其他医院和 8 家门诊实践）的患者和幸存者（n=1309）参与了研究；88.3%的患者在疾病的某个阶段在 IDTB 中进行了讨论（56.1%在治疗前，78%在治疗后，85.9%在转移性疾病中）。关于认证癌症中心（与其他所有中心相比：OR=5.39；95%CI 3.28-8.85）和诊断时间（2018/2019 年与直到 2013 年相比：OR=4.95；95%CI 2.67-9.21）使用 IDTB 的假设得到了证实。
我们的研究增加了关于德国肉瘤治疗机构结构的证据。在治疗前使用肿瘤委员会似乎正在进行一项进展但远未完成的实施过程。认证是加速这一发展的一种可能工具。
