Therapiequalität bei gynäkologischen Malignomen: Retrospektiver Vergleich des zertifizierten gynäkologischen Krebszentrums des Universitätsklinikums Marburg mit peripheren gynäkologischen Abteilungen

Today in gynecologic oncology a variety in the outcome of patients is seen and individual multidisciplinary decisions in therapy are needed. The impact of a multidisciplinary team is shown in many studies(121,122,124,130). To improve decisionmaking for specific tumor therapy tumorboards were invented. This study compares the outcome of out-clinic patients with patients treated in a cancer center, both presented in one tumorboard. The aim of our study is to show an impact of a weekly tumorboard on patient overall survival. Methods: This study is based on retrospective data of 848 patients, 434 patients from UKGM com-pared with 414 out-clinic patients presented in a tumorboard from 06/2008 until 12/2010. All gynecologic malignancies were included, except for breast-cancer. We descriptively compared patient characteristics like age, diagnosis, stadium, grading, and relapse. By Cox-Regression the influence of the factors clinic, age, and stadium on survival were analyzed. Results: Our results show a wide range of patient characteristics. Tumors in advanced stages were more often presented by UKGM. Only for vulva-cancer the factor clinic has a significant impact (=98, p=0,017, HR=5,032, 95% KI 1,333-19,002). Age is a factor of influence in the case of ovarian cancer (p=0,016, HR 1,021) as well as tumor-stadium for ovarian, endome-trial, and cervix cancer. Survival-time differs up to 10 months depending on diagnosis. The greatest difference was shown in vulva-cancer with 33,18 months patients of UKGM versus 23,27 months in out-clinic patients (p=0,278). Opposite to this is the difference for ovarian cancer with only one month (24,11 months vs. 25,82 months out-clinic patients, p=0,652). Discussion: This study shows a significant effect of the factor clinic on survival only in one type of tu-mor. This suggests that patient-care in gynecology can be improved by presenting patients in an interdisciplinary tumorboard. However, further studies are needed to analyze the effects of tumorboards on patient-care. 121 Greer 2010; 122 Du Bois 2009; 124 Bouchardy 2007; 130 Mercado 2010