Comparison of survival in ovarian cancer patients following treatment in certified gynecologic oncology centers and non-certified hospitals: a German retrospective cohort study (WiZen)

URN to cite this document:

urn:nbn:de:bvb:355-epub-780812 Copy

DOI to cite this document:

10.5283/epub.78081 Copy

Hansinger, Judith ; Schoffer, Olaf ; Völkel, Vinzenz ; Gerken, Michael ; Wimberger, Pauline ; Bierbaum, Veronika ; Bobeth, Christoph ; Rößler, Martin ; Dröge, Patrik ; Ruhnke, Thomas ; Günster, Christian ; Kleihues-van Tol, Kees ; Link, Theresa ; Kast, Karin ; Papathemelis, Thomas ; Ortmann, Olaf ; Schmitt, Jochen ; Klinkhammer-Schalke, Monika

License: Creative Commons Attribution 4.0 PDF - Published Version (1MB)

Date of publication of this fulltext: 18 Nov 2025 11:29

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Details

Item type:	Article
Open Access Type:	DEAL (Springer Gold)
Journal or Publication Title:	Journal of Ovarian Research
Publisher:	Springer
Volume:	18
Number of Issue or Book Chapter:	1
Date:	4 November 2025
Institutions:	Medicine > Lehrstuhl für Frauenheilkunde und Geburtshilfe (Schwerpunkt Frauenheilkunde) Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V. Medicine > Institut für Epidemiologie und Präventivmedizin > Tumorzentrum e.V.
Identification Number:	Value Type 10.1186/s13048-025-01843-8 DOI
Keywords:	Certification, Outcome quality, Health services research, Healthcare-related data, Specialized treatment
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Partially
Item ID:	78081

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Abstract

Background Ovarian cancer is the most lethal gynecologic cancer. This study explores differences in observed survival rates among ovarian cancer patients treated in certified versus non-certified hospitals in Germany. Methods The study used data from German statutory health insurance (SHI) funds and clinical cancer registries (CCRs), including 20,794 insured and 4,493 registry patients ...

Abstract

Background
Ovarian cancer is the most lethal gynecologic cancer. This study explores differences in observed survival rates among ovarian cancer patients treated in certified versus non-certified hospitals in Germany.
Methods
The study used data from German statutory health insurance (SHI) funds and clinical cancer registries (CCRs), including 20,794 insured and 4,493 registry patients diagnosed with a malignant ovarian neoplasm (ICD-10-GM code C56) from 2009 to 2017. Patients were categorized based on whether they received primary treatment at hospitals certified as ovarian cancer centers by the German Cancer Society (DKG) or at non-certified hospitals. Survival analyses were conducted using Kaplan–Meier and multivariable Cox regression methods. Adjustments were performed for age, year of diagnosis, International Union Against Cancer (UICC) stage, grade, lymphatic and venous invasion, year of index treatment, distant metastasis, Elixhauser comorbidities, and hospital criteria where available in the data source used.
Results
After adjustment for various confounders, treatment in certified centers was associated with a lower mortality risk, corresponding to a hazard ratio (HR) of 0.883 (95% CI 0.824–0.948; p = 0.001) in the SHI data. In the CCR data a non-significant HR of 0.964 was observed (95% CI 0.867–1.071; p = 0.490). Among patients in the CCR cohort diagnosed with UICC stage I–III disease, receiving treatment at certified centers was associated with improved survival outcomes (HR 0.825, 95% CI 0.708–0.961; p = 0.014).
Conclusion
Treatment in DKG-certified centers is associated with better survival in ovarian cancer patients, especially in earlier stages. Certification status may be a relevant factor when choosing a treatment facility.

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