Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, 97080 Würzburg, Germany; Department of Urology and Pediatric Urology, University Hospital Würzburg, 97080 Würzburg, Germany.
Institute of Pathology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, 91054 Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN, 91054 Erlangen, Germany.
Eur J Cancer. 2024 Aug;207:114144. doi: 10.1016/j.ejca.2024.114144. Epub 2024 May 31.
Providing patient access to precision oncology (PO) is a major challenge of clinical oncologists. Here, we provide an easily transferable model from strategic management science to assess the outreach of a cancer center.
As members of the German WERA alliance, the cancer centers in Würzburg, Erlangen, Regensburg and Augsburg merged care data regarding their geographical impact. Specifically, we examined the provenance of patients from WERA´s molecular tumor boards (MTBs) between 2020 and 2022 (n = 2243). As second dimension, we added the provenance of patients receiving general cancer care by WERA. Clustering our catchment area along these two dimensions set up a four-quadrant matrix consisting of postal code areas with referrals towards WERA. These areas were re-identified on a map of the Federal State of Bavaria.
The WERA matrix overlooked an active screening area of 821 postal code areas - representing about 50 % of Bavaria´s spatial expansion and more than six million inhabitants. The WERA matrix identified regions successfully connected to our outreach structures in terms of subsidiarity - with general cancer care mainly performed locally but PO performed in collaboration with WERA. We also detected postal code areas with a potential PO backlog - characterized by high levels of cancer care performed by WERA and low levels or no MTB representation.
The WERA matrix provided a transparent portfolio of postal code areas, which helped assessing the geographical impact of our PO program. We believe that its intuitive principle can easily be transferred to other cancer centers.
为患者提供精准肿瘤学（PO）服务是临床肿瘤学家面临的主要挑战。在这里，我们提供了一个易于从战略管理科学转移的模型，以评估癌症中心的服务范围。
作为德国 WERA 联盟的成员，维尔茨堡、埃尔兰根、雷根斯堡和奥格斯堡的癌症中心合并了其地理影响方面的护理数据。具体来说，我们研究了 2020 年至 2022 年期间 WERA 分子肿瘤委员会（MTB）患者的来源（n=2243）。作为第二个维度，我们添加了 WERA 接受一般癌症护理的患者的来源。根据这两个维度对我们的集水区进行聚类，建立了一个由 WERA 转诊的邮政编码区域组成的四象限矩阵。这些区域在巴伐利亚联邦州的地图上重新进行了标识。
WERA 矩阵覆盖了一个 821 个邮政编码区域的主动筛查区域-代表了巴伐利亚州空间扩展的约 50%和超过 600 万居民。WERA 矩阵成功地识别了与我们的援助结构在辅助性方面相联系的区域-主要在当地提供一般癌症护理，但 PO 是与 WERA 合作进行的。我们还检测到了 PO 积压的潜在邮政编码区域-其特点是 WERA 提供的癌症护理水平高，而 MTB 的代表性低或没有。
WERA 矩阵提供了一个透明的邮政编码区域组合，有助于评估我们 PO 计划的地理影响。我们相信，其直观的原则可以很容易地转移到其他癌症中心。
