Richter Maximilian, Sonnow Lena, Mehdizadeh-Shrifi Amir, Richter Axel, Koch Rainer, Zipprich Alexander
Practice Centre Rethen, Centre for General Medicine, Academic Teaching Practice of Hannover Medical School, Hannover, Germany.
Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany.
Innov Surg Sci. 2021 Apr 30;6(2):67-73. doi: 10.1515/iss-2021-0002. eCollection 2021 Jun.
To evaluate how the certification of specialised Oncology Centres in Germany affects the relative survival of patients with colorectal cancer (CRC) by means of national and international comparison.
Between 2007 and 2013, 675 patients with colorectal cancer, treated at the Hildesheim Hospital, an academic teaching hospital of the Hannover Medical School (MHH), were included. A follow-up of the entire patient group was performed until 2014. To obtain international data, a SEER-database search was done. The relative survival of 148,957 patients was compared to our data after 12, 36 and 60 months. For national survival data, we compared our rates with 41,988 patients of the Munich Cancer Registry (MCR).
Relative survival at our institution tends to be higher in advanced tumour stages compared to national and international cancer registry data. Nationally we found only little variation in survival rates for low stages CRC (UICC I and II), colon, and rectal cancer. There were notable variations regarding relative survival rates for advanced CRC tumour stages (UICC IV). These variations were even more distinct for rectal cancer after 12, 36 and 60 months (Hildesheim Hospital: 89.9, 40.3, 30.1%; Munich Cancer Registry (MCR): 65.4, 28.7, 16.6%). The international comparison of CRC showed significantly higher relative survival rates for patients with advanced tumour stages after 12 months at our institution (77 vs. 54.9% for UICC IV; raw p<0.001).
Our findings suggest that patients with advanced tumour stages of CRC and especially rectal cancer benefit most from a multidisciplinary and guidelines-oriented treatment at Certified Oncology Centres. For a better evaluation of cancer treatment and improved national and international comparison, the creation of a centralised national cancer registry is necessary.
通过国内和国际比较，评估德国专门肿瘤中心的认证对结直肠癌（CRC）患者相对生存率的影响。
纳入2007年至2013年间在汉诺威医学院（MHH）的学术教学医院希尔德斯海姆医院接受治疗的675例结直肠癌患者。对整个患者组进行随访直至2014年。为获取国际数据，进行了监测、流行病学和最终结果（SEER）数据库搜索。将148,957例患者的相对生存率与我们的数据在12、36和60个月后进行比较。对于国内生存数据，我们将我们的比率与慕尼黑癌症登记处（MCR）的41,988例患者进行比较。
与国内和国际癌症登记数据相比，我们机构晚期肿瘤阶段的相对生存率往往更高。在国内，我们发现低阶段结直肠癌（国际抗癌联盟（UICC）I和II期）、结肠癌和直肠癌的生存率差异很小。晚期结直肠癌肿瘤阶段（UICC IV期）的相对生存率存在显著差异。这些差异在12、36和60个月后对于直肠癌更为明显（希尔德斯海姆医院：89.9%、40.3%、30.1%；慕尼黑癌症登记处（MCR）：65.4%、28.7%、16.6%）。结直肠癌的国际比较显示，我们机构在12个月后晚期肿瘤阶段患者的相对生存率显著更高（UICC IV期为77%对54.9%；原始p<0.001）。
我们的研究结果表明，晚期结直肠癌患者，尤其是直肠癌患者，从认证肿瘤中心的多学科和以指南为导向的治疗中获益最大。为了更好地评估癌症治疗并改善国内和国际比较，有必要建立一个集中的国家癌症登记处。
