Do head and neck cancer patients benefit from treatment in certified centres? Specific results of the WiZen study for head and neck cancers

Background In Germany, around 16,000 new patients are diagnosed with a head and neck cancer (HNC) every year. The individual treatment concepts should be determined on an interdisciplinary basis and carried out according to current guidelines. To ensure this, the national cancer plan was implemented in 2008. Since then, 76 head and neck tumour centres (HNCC) (78 locations) have been certified by the German Hospital Association (DKG). Certification is very challenging, both financially and in terms of personnel. The question therefore arises as to whether HNC patients really benefit from treatment in certified HNCC.

Methods In the WiZen study, patient-specific data from statutory health insurance (GKV) of AOK and clinical cancer registries (CCR) from 2009 to 2017 as well as hospital characteristics from the structured quality reports were analysed. Multivariable Cox regression was used to analyse the differences in the survival of HNC patients who were initially treated in hospitals with and without a certificate.

Results It was possible to analyse 52,749 HNC patient records from the GKV and 15,287 from the CCR. These were initially treated in 872 hospitals (44 with vs. 828 without a certificate). Accordingly, 15.5% (GKV) and 25.9% (CCR) of patients were treated in certified HNCC. The mortality risk for treatment in a certified HNCC was significantly lower in comparison (SHI data: HR=0.94; CCR data: HR=0.89). The significant difference in recurrence-free survival was even more pronounced (CCR data: HR=0.81).

Conclusion The WiZen study shows that treatment in a DKG-certified KHT centre is associated with lower mortality. Centralising the care of HNC-patients to certified HNCC therefore seems sensible.

Funding information Innovation Fund of the Joint Federal Committee, (Gemeinsamer Bundesausschluss, G-BA), Germany | Funding number 01CSF17020

Publication History

Article published online:
19 April 2024