Universität zu Köln

Klimm, Beate, Brillant, Corinne, Skoetz, Nicole ORCID: 0000-0003-4744-6192, Mueller, Horst, Engert, Andreas and Borchmann, Peter (2012). The Effect of Specialized Cancer Treatment Centers on Treatment Efficacy in Hodgkin's Lymphoma. Dtsch. Arztebl. Int., 109 (51-52). S. 893 - 900. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: The presumed benefits of centralization and minimum case numbers often guide health-policy decisions, but these benefits remain inadequately documented, particularly in oncology. In this study, we aim to measure the effect of the type of treatment center and/or the number of patients treated in it on the outcome of patients with Hodgkin's lymphoma. Methods: From 1988 to 2002, 8121 patients with newly diagnosed Hodgkin's lymphoma were treated in Germany in multicenter randomized and controlled trials (RCTs) of the German Hodgkin Study Group (GHSG). Center-related effects on progression-free survival (PFS) were assessed univariately with Kaplan-Meier plots and log-rank tests, as well as with a multivariate Cox regression model. Results: The 500 participating centers in Germany included 52 university hospitals, 304 non-university hospitals, and 144 medical practices specializing in hematology and oncology. No significant differences in PFS were found between patients from centers with high or low case numbers (5-year-PFS: 78.7% and 78.6% for centers with fewer than 50 and more than 50 patients, respectively) or from different types of centers [5-year-PFS: university hospital, 77.7%; non-university hospital, 79.4%; practice, 79.8%]. Even after statistical controls for the effect of other known and unknown prognostic factors and validation in further datasets, no center effects were found. Conclusions: The type of center and the minimum number of patients treated in a center have no impact on the treatment outcome of patients with Hodgkin's lymphoma in Germany. In all GHSG centers, regardless of type, the quality standards for successful treatment are apparently met on all levels of patient care.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Klimm, Beate UNSPECIFIED UNSPECIFIED UNSPECIFIED Brillant, Corinne UNSPECIFIED UNSPECIFIED UNSPECIFIED Skoetz, Nicole UNSPECIFIED orcid.org/0000-0003-4744-6192 UNSPECIFIED Mueller, Horst UNSPECIFIED UNSPECIFIED UNSPECIFIED Engert, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Borchmann, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-476508
DOI:	10.3238/arztebl.2012.0893
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	109
Number:	51-52
Page Range:	S. 893 - 900
Date:	2012
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTENDED-FIELD RADIOTHERAPY; OF-THE-LITERATURE; PHARMACEUTICAL COMPANIES; UNITED-STATES; DRUG TRIALS; DISEASE; VOLUME; CARE; CHEMOTHERAPY; OUTCOMES Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47650