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

Zum heutigen Zeitpunkt heißt Tumortherapie in der gynäkologischen Onkologie individuelle und multidisziplinäre Therapieentscheidung. Es ist eine deutliche Heterogenität im Outcome der Patientinnen zu beobachten. Einige Studien konnten zeigen, dass die ausgewählte Klinik bzw. Multidisziplinarität ein...

Full description

Saved in:
Bibliographic Details
Main Author: Trabert, Leona Maria
Contributors: Wagner, Uwe (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2016
Online Access:PDF Full Text
Tags: Add Tag
No Tags, Be the first to tag this record!

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