Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 153 No. 7 (2023)

A long-term retrospective observational study at a medium-sized medical oncology service in Switzerland: comparison of overall survival with a national cohort and adherence to treatment guidelines

  • Mirjam Gross-Erne
  • Lukas Zimmerli
  • Stefano Bassetti
  • Qiyu Li
  • Anita Feller
  • Walter Mingrone
DOI
https://doi.org/10.57187/smw.2023.40091
Cite this as:
Swiss Med Wkly. 2023;153:40091
Published
17.07.2023

Summary

AIMS: There is a lack of national and international publicly available long-term survival outcome data from individual healthcare providers in medical oncology. In this study, the overall survival at a medium-sized medical oncology service at Olten Cantonal Hospital was evaluated and compared as a local benchmark report with national data from the Swiss Cancer Registries. Furthermore, adherence to treatment guidelines was investigated as an additional quality indicator.

METHODS: The 1- and 5-year overall survival of all patients with breast cancer, testicular cancer, colon cancer, non-small-cell lung cancer, Hodgkin lymphoma, and diffuse large B-cell lymphoma in Switzerland from 2008 to 2017 with at least one outpatient visit at the in-house medical oncology service at Olten Cantonal Hospital was analysed and compared with the specific overall population-based outcome data provided by the National Agency for Cancer Registration (NACR), which were set as a national benchmark. Until 2020, no data from the Canton of Solothurn, to which Olten belongs, were reported to the NACR. Further, adherence to internationally recognized clinical guidelines for stage-specific treatment was assessed.

RESULTS: Until September 8, 2020, data on 842 patients with a median follow-up period of 70 months were collected and analysed. The 1- and 5-year overall survival for colon and non-small cell cancer, Hodgkin lymphoma, and diffuse large B-cell lymphoma and the 5-year overall survival for testicular cancer in the Olten cohort did not significantly differ from the NACR data. The 1-year overall survival for testicular cancer was not comparable statistically. The 5-year overall survival for breast cancer (unadjusted for stage) was significantly higher in the NACR collective (84.5%) than in the Olten collective (79.7%) but not for the individual breast cancer stages. The Olten collective included approximately 2.5 times as many patients with stage 4 breast cancer (17.5%) as the NACR collective (6.9%). Approximately 92.4% of the patients in the curative setting and 85.8% of the patients in the palliative setting received first-line treatment according to guidelines.

CONCLUSIONS: The statistically comparable local 1- and 5-year overall survival of the analysed malignancies, with adjustment for stage for the 5-year overall survival for breast cancer, is in line with the national benchmark. Adherence to treatment guidelines is high.

References

  1. Art. 59a (Daten der Leistungserbringer) Bundesgesetz as of 18 March 1994 über die Krankenversicherung (KVG; SR 832.10).
  2. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington (DC). US: National Academies Press; 2001.
  3. D’Amico TA, Bandini LA, Balch A, Benson AB, Edge SB, Fitzgerald CL, et al. Quality measurement in cancer care: a review and endorsement of high-impact measures and concepts. J Natl Compr Canc Netw. 2020 Mar;18(3):250–9. 10.6004/jnccn.2020.7536 DOI: https://doi.org/10.6004/jnccn.2020.7536
  4. Colosia AD, Peltz G, Pohl G, Liu E, Copley-Merriman K, Khan S, et al. A review and characterization of the various perceptions of quality cancer care. Cancer. 2011 Mar;117(5):884–96. 10.1002/cncr.25644 DOI: https://doi.org/10.1002/cncr.25644
  5. Ramsdale EE, Csik V, Chapman AE, Naeim A, Canin B. Improving quality and value of cancer care for older adults. Am Soc Clin Oncol Educ Book. 2017;37(37):383–93. 10.1200/EDBK_175442 DOI: https://doi.org/10.1200/EDBK_175442
  6. Swiss Society of Medical Oncology SSMO [Internet]. Basel: Swiss Society of Medical Oncology; c2019 [cited 2022 June 18]. Zertifikat Beantragen; [about 2 screens]. Available from: https://www.sgmo.ch/qualitaetssicherung/zertifikat-beantragen/#
  7. German Cancer Society [Internet]. Berlin: Deutsche Krebsgesellschaft e. V., c2021 [cited 2022 September 22]. Certification; [about 2 screens]. Available from: https://www.krebsgesellschaft.de/gcs/german-cancer-society/certification.html
  8. Boland GM, Chang GJ, Haynes AB, Chiang YJ, Chagpar R, Xing Y, et al. Association between adherence to National Comprehensive Cancer Network treatment guidelines and improved survival in patients with colon cancer. Cancer. 2013 Apr;119(8):1593–601. 10.1002/cncr.27935 DOI: https://doi.org/10.1002/cncr.27935
  9. Visser BC, Ma Y, Zak Y, Poultsides GA, Norton JA, Rhoads KF. Failure to comply with NCCN guidelines for the management of pancreatic cancer compromises outcomes. HPB (Oxford). 2012 Aug;14(8):539–47. 10.1111/j.1477-2574.2012.00496.x DOI: https://doi.org/10.1111/j.1477-2574.2012.00496.x
  10. Smith TG, Castro KM, Troeschel AN, Arora NK, Lipscomb J, Jones SM, et al. The rationale for patient-reported outcomes surveillance in cancer and a reproducible method for achieving it. Cancer. 2016 Feb;122(3):344–51. 10.1002/cncr.29767 DOI: https://doi.org/10.1002/cncr.29767
  11. Berardi R, Morgese F, Rinaldi S, Torniai M, Mentrasti G, Scortichini L, et al. Benefits and limitations of a multidisciplinary approach in cancer patient management. Cancer Manag Res. 2020 Sep;12:9363–74. 10.2147/CMAR.S220976 DOI: https://doi.org/10.2147/CMAR.S220976
  12. Ess S, Savidan A, Frick H, Rageth C, Vlastos G, Lütolf U, et al. Geographic variation in breast cancer care in Switzerland. Cancer Epidemiol. 2010 Apr;34(2):116–21. 10.1016/j.canep.2010.01.008 DOI: https://doi.org/10.1016/j.canep.2010.01.008
  13. Bourbeau B, Harter D, Towle E. Results From the ASCO 2019 Survey of Oncology Practice Operations. JCO Oncol Pract. 2020 May;16(5):253–62. 10.1200/OP.20.00009 DOI: https://doi.org/10.1200/OP.20.00009
  14. Konferenz der kantonalen Gesundheitsdirektorinnen und –direktoren [Internet] Bern: GDK; c2022 [cited 2022 September 22]. HSM-Planungsverfahren; [about 2 screens]. Available from: https://www.gdk-cds.ch/de/hochspezialisierte-medizin/hsm-planungsverfahren
  15. Lorez M, Bordoni A, Bouchardy C, Bulliard JL, Camey B, Dehler S, et al. Evaluation of completeness of case ascertainment in Swiss cancer registration. Eur J Cancer Prev. 2017 Sep;26 Joining forces for better cancer registration in Europe:139-46. 10.1097/CEJ.0000000000000380 DOI: https://doi.org/10.1097/CEJ.0000000000000380
  16. National Comprehensive Cancer Network [Internet]. Plymouth Meeting (PA): National Comprehensive Cancer Network; c2022. [cited 2022 Sep 28]. NCCN Guidelines Treatment by Cancer Type. Available from: https://www.nccn.org/professionals/physician_gls/default.aspx
  17. European Society for Medical Oncology [Internet]. Lugano: European Society for Medical Oncology; c2022. [cited 2022 Sep 28]. ESMO Clinical Practice Guidelines. Available from: https://www.esmo.org/guidelines
  18. American Society of Clinical Oncology [Internet]. Alexandria (VA): American Society of Clinical Oncology (ASCO); c2022. [cited 2022 Sep 28]. Guidelines, tools, resources. Available from: https://www.asco.org/research-guidelines/quality-guidelines/guidelines
  19. Koziol JA, Jia Z. The concordance index C and the Mann-Whitney parameter Pr(X>Y) with randomly censored data. Biom J. 2009 Jun;51(3):467–74. 10.1002/bimj.200800228 DOI: https://doi.org/10.1002/bimj.200800228
  20. Garrett TM, Baillie HM, Garrett RM. The ethics of distribution. In: Garrett TM, Baillie HM, Garrett RM, editors. Health care ethics: principles and problems. 5th ed. Upper Saddle River (NJ): Pearson; 2010. pp. 83–7.
  21. Heins MJ, de Jong JD, Spronk I, Ho VK, Brink M, Korevaar JC. Adherence to cancer treatment guidelines: influence of general and cancer-specific guideline characteristics. Eur J Public Health. 2017 Aug;27(4):616–20. DOI: https://doi.org/10.1016/S0959-8049(17)30458-6
  22. van de Water W, Bastiaannet E, Dekkers OM, de Craen AJ, Westendorp RG, Voogd AC, et al. Adherence to treatment guidelines and survival in patients with early-stage breast cancer by age at diagnosis. Br J Surg. 2012 Jun;99(6):813–20. 10.1002/bjs.8743 DOI: https://doi.org/10.1002/bjs.8743
  23. Jochum F, De Rozario T, Lecointre L, Faller E, Boisrame T, Dabi Y, et al. Adherence to European ovarian cancer guidelines and impact on survival: a French multicenter study (FRANCOGYN). Int J Gynecol Cancer. 2021 Nov;31(11):1443–52. 10.1136/ijgc-2021-002934 DOI: https://doi.org/10.1136/ijgc-2021-002934
  24. Aerzteblatt.de. [Internet]. Berlin: Deutscher Ärzteverlag GmbH; c2022 [cited 2022 Sep 28]. Geringere Sterblichkeit bei Therapie in zertifizierten Krebszentren; [about 3 screens]. Available from: https://www.aerzteblatt.de/nachrichten/133643/Geringere-Sterblichkeit-bei-Therapie-in-zertifizierten-Krebszentren
  25. Klimm B, Brillant C, Skoetz N, Müller H, Engert A, Borchmann P. The effect of specialized cancer treatment centers on treatment efficacy in Hodgkin’s lymphoma. Dtsch Arztebl Int. 2012 Dec;109(51-52):893–9. 10.3238/arztebl.2012.0893 DOI: https://doi.org/10.3238/arztebl.2012.0893
  26. Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002 Apr;346(15):1128–37. 10.1056/NEJMsa012337 DOI: https://doi.org/10.1056/NEJMsa012337
  27. Huo YR, Phan K, Morris DL, Liauw W. Systematic review and a meta-analysis of hospital and surgeon volume/outcome relationships in colorectal cancer surgery. J Gastrointest Oncol. 2017 Jun;8(3):534–46. 10.21037/jgo.2017.01.25 DOI: https://doi.org/10.21037/jgo.2017.01.25
  28. Gooiker GA, van Gijn W, Post PN, van de Velde CJ, Tollenaar RA, Wouters MW. A systematic review and meta-analysis of the volume-outcome relationship in the surgical treatment of breast cancer. Are breast cancer patients better of with a high volume provider? Eur J Surg Oncol. 2010 Sep;36 Suppl 1:S27–35. 10.1016/j.ejso.2010.06.024 DOI: https://doi.org/10.1016/j.ejso.2010.06.024
  29. Stahel RA, Curioni-Fontecedro A, Rohrmann S, Dafni U, Sandner U, Opitz I, et al. Survival outcome of non-small cell lung cancer patients: Comparing results between the database of the Comprehensive Cancer Center Zürich and the Epidemiological Cancer Registry Zurich and Zug. Lung Cancer. 2020 Aug;146:217–23. 10.1016/j.lungcan.2020.05.037 DOI: https://doi.org/10.1016/j.lungcan.2020.05.037
  30. Baker R. History of medical ethics. In: Bynum WF, Porter R, editors. Companion encyclopedia of the history of medicine. 1st ed. London: Routledge; 1993. p. 860.
  31. Hastings Center. The goals of medicine. Setting new priorities. Hastings Cent Rep. 1996;26(6):S1–27. 10.2307/3528765 DOI: https://doi.org/10.2307/3528765
  32. Black N. Patient reported outcome measures could help transform healthcare. BMJ. 2013 Jan;346 jan28 1:f167. 10.1136/bmj.f167 DOI: https://doi.org/10.1136/bmj.f167
  33. Cook O, Daiyan Y, Yeganeh L, Davies AG, Kwok A, Webber K, et al. Exploration of the use and impact of patient-reported experience measures (PREMs) in oncology settings: a systematic review. J Clin Oncol. 2020 Oct;38(29_suppl Suppl 29):166. 10.1200/JCO.2020.38.29_suppl.166 DOI: https://doi.org/10.1200/JCO.2020.38.29_suppl.166
  34. American Cancer Society [Internet]. Atlanta: American Cancer Society, Inc; c2019 [cited 2021 August 20]. Breast cancer facts & figures 2019-2020; [about 44 pages]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2019-2020.pdf
  35. Fallahpour S, Navaneelan T, De P, Borgo A. Breast cancer survival by molecular subtype: a population-based analysis of cancer registry data. CMAJ Open. 2017 Sep;5(3):E734–9. 10.9778/cmajo.20170030 DOI: https://doi.org/10.9778/cmajo.20170030
  36. Howlader N, Forjaz G, Mooradian MJ, Meza R, Kong CY, Cronin KA, et al. The effect of advances in lung-cancer treatment on population mortality. N Engl J Med. 2020 Aug;383(7):640–9. 10.1056/NEJMoa1916623 DOI: https://doi.org/10.1056/NEJMoa1916623
  37. Bundesgesetz as of 18 March 2016 über die Registrierung von Krebserkrankungen (Krebsregistrierungsgesetz [Cancer Registration Act] KRG; SR 818.33).
  38. Søgaard M, Thomsen RW, Bossen KS, Sørensen HT, Nørgaard M. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013 Nov;5 Suppl 1:3–29. 10.2147/CLEP.S47150 DOI: https://doi.org/10.2147/CLEP.S47150

Most read articles by the same author(s)

1 2 3 > >>