Introduction: Medical care of soft-tissue sarcoma (STS) and bone sarcoma (BS) patients in Germany has rarely been investigated. The objectives of this article were (1) to investigate medical care and survival in STS and BS patients, and (2) to examine methodological aspects of corresponding analyses based on administrative healthcare data. Methods: We analyzed data from a statutory health insurance located in Saxony, Germany, covering approximately 2 million individuals. We identified incident STS and BS patients in the period 2012–2016 using 4 different case definitions. We examined treatment rates and visits to medical oncologists and medical practices descriptively, and then compared results between case definitions. We investigated survival prospects using a relative survival analysis and estimated hazard ratios (HRs) for risk factors for mortality using Cox regression. Results: Across case definitions, the number of included sarcoma patients (STS: n = 871–1,757; BS: n = 216–689) and applied treatments (STS: 42.2–83.1%; BS: 28.3–77.8%) varied substantially. Irrespective of the case definition, the minority of patients visited medical oncologists (STS: 9.8–10.8% BS: 4.4–7.9%) and “experienced” medical practices (STS: 27.7–38.4%; BS: 18.3–23.6%). Survival prospects were better for patients who visited “experienced” medical practices (STS: HR = 0.55; BS: HR = 0.42). Conclusion: Treatment rates clearly <100% and evidence from survival analyses indicate the potential for improvements in the care of sarcoma patients in Germany, e.g., by physicians in “experienced” medical practices.

1.
Ressing
M
,
Wardelmann
E
,
Hohenberger
P
,
Jakob
J
,
Kasper
B
,
Emrich
K
, et al
Strengthening health data on a rare and heterogeneous disease: sarcoma incidence and histological subtypes in Germany
.
BMC Public Health
.
2018
Feb
;
18
(
1
):
235
.
[PubMed]
1471-2458
2.
Saltus
CW
,
Calingaert
B
,
Candrilli
S
,
Lorenzo
M
,
D’yachkova
Y
,
Otto
T
, et al
Epidemiology of Adult Soft-Tissue Sarcomas in Germany
.
Sarcoma
.
2018
Apr
;
2018
:
5671926
.
[PubMed]
1357-714X
3.
Robert Koch Institut
. Zentrum für Registerdaten, Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. Krebs in Deutschland für 2015/2016.
2019
[cited 2020 Jun 22]. Available from: https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/krebs_in_deutschland_node.html
4.
Siegel
GW
,
Biermann
JS
,
Chugh
R
,
Jacobson
JA
,
Lucas
D
,
Feng
M
, et al
The multidisciplinary management of bone and soft tissue sarcoma: an essential organizational framework
.
J Multidiscip Healthc
.
2015
Feb
;
8
:
109
15
.
[PubMed]
1178-2390
5.
Bagaria
SP
,
Neville
M
,
Gray
RJ
,
Gabriel
E
,
Ashman
JB
,
Attia
S
, et al
The Volume-Outcome Relationship in Retroperitoneal Soft Tissue Sarcoma: Evidence of Improved Short- and Long-Term Outcomes at High-Volume Institutions
.
Sarcoma
.
2018
Jul
;
2018
:
3056562
.
[PubMed]
1357-714X
6.
Eichler
M
,
Richter
S
,
Hohenberger
P
,
Kasper
B
,
Andreou
D
,
Heidt
V
, et al
Current State of Sarcoma Care in Germany: Results of an Online Survey of Physicians
.
Oncol Res Treat
.
2019
;
42
(
11
):
589
98
.
[PubMed]
2296-5270
7.
Comprehensive Cancer Center Freiburg
.
Kodierhilfe Knochentumor und Tumor der Gelenkknorpel.
2014
[cited 2020 Jun 22]. Available from: https://www.uniklinik-freiburg.de/fileadmin/mediapool/09_zentren/cccf/pdf/cccf_kkr_kodierhilfe_knochentumor.pdf
8.
Comprehensive Cancer Center Freiburg
.
Kodierhilfe Weichteiltumor.
2014
[cited 2020 Jun 22]. Available from: https://www.uniklinik-freiburg.de/fileadmin/mediapool/09_zentren/cccf/pdf/cccf_kkr_kodierhilfe_weichteiltumor.pdf
9.
Trautmann
F
,
Singer
S
,
Schmitt
J
.
Patients with soft tissue sarcoma comprise a higher probability of comorbidities than cancer-free individuals. A secondary data analysis
.
Eur J Cancer Care (Engl)
.
2017
Nov
;
26
(
6
):
e12605
.
[PubMed]
0961-5423
10.
Bundesministerium für Gesundheit (BMG). Zahlen und Fakten zur Krankenversicherung [Internet].
2020
[cited 2020 Jun 22]. Available from: https://www.bundesgesundheitsministerium.de/themen/krankenversicherung/zahlen-und-fakten-zur-krankenversicherung.html
11.
Swart
E
,
Gothe
H
,
Geyer
S
,
Jaunzeme
J
,
Maier
B
,
Grobe
TG
, et al;
German Society for Social Medicine and Prevention
;
German Society for Epidemiology
.
Gute Praxis Sekundärdatenanalyse (GPS): leitlinien und Empfehlungen
.
Gesundheitswesen
.
2015
Feb
;
77
(
2
):
120
6
.
[PubMed]
0941-3790
12.
Hauswaldt
J
,
Hummers-Pradier
E
,
Junius-Walker
U
.
Health service use among patients with chronic or multiple illnesses, and frequent attenders: secondary analysis of routine primary care data from 1996 to 2006
.
Dtsch Arztebl Int
.
2012
Nov
;
109
(
47
):
814
20
.
[PubMed]
1866-0452
13.
Princic
N
,
McMorrow
D
,
Chan
P
,
Hess
L
.
Evaluation of the accuracy of algorithms to identify soft tissue sarcoma (STS) in administrative claims
.
Clin Sarcoma Res
.
2020
May
;
10
(
1
):
8
.
[PubMed]
2045-3329
14.
Czwikla
J
,
Domhoff
D
,
Giersiepen
K
.
ICD-Codierqualität ambulanter Krebsdiagnosen in GKV-Routinedaten
.
Z Für Evidenz Fortbild Qual Im Gesundheitswesen.
2016
;
118–119
:
48
55
.
15.
Schoffer
O
,
Niedostatek
A
,
Klug
SJ
.
Estimation of Relative Survival Based on Cancer Registry Data
.
Rev Bioinforma Biom.
2013
;
2
(
4
):
77
80
.
16.
Cleves
MA
,
Gould
W
,
Marchenko
YV
.
An introduction to survival analysis using Stata
. 3rd ed.
College Station (Texas)
:
Stata Press
;
2016
.
17.
World Health Organization (WHO)
. ICD-11 [Internet].
2020
[cited 2020 Jun 22]. Available from: https://icd.who.int/en
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