Treatment of colorectal cancer in certified bowel cancer centers: A retrospective observational study with innovative data acquisition

Kampfenkel T., Arning A., Heidinger O., Jürgens H., Koch R.

Abstract

Background: In 2014, 41 % of all colorectal cancer patients in North Rhine-Westphalia (NRW) were treated in a certified cancer center, with rising tendency. While positive outcomes have been shown for surrogate parameters in certified bowel cancer centers, the influence of center certification on patient-relevant outcomes has so far remained unclear. In general, the classic endpoint with the highest patient relevance in oncology is overall survival. Objective: The present study investigated whether there is a difference in overall survival between colorectal cancer patients who have been treated in a certified cancer center versus those treated in a non-certified center. Methods: A non-interventional retrospective observational study using routine data from a statutory health insurance fund (AOK Nordwest) supplemented by data from the Epidemiological Cancer Register NRW was performed. Statistical analyses of overall survival were performed using multivariate methods. Results: Tumor stage, age at initial diagnosis, care level, end-stage renal disease, and dementia were associated with statistically noticeable effects on overall survival. However, no significant difference in overall survival could be observed between patients treated in certified cancer centers versus patients treated in non-certified centers (hazard ratio = 1.043, 95 % CI 0.893–1.219; p = 0.592). Conclusion: This analysis revealed no statistically noticeable difference in overall survival between patients treated in a certified cancer center versus patients treated in a non-certified cancer center. However, due to study limitations, this outcome must be interpreted with caution. The applied methodology cannot replace comprehensive evaluations based on data generated from clinical cancer registries.