[Does structural and process quality of certified prostate cancer centers result in better medical care?]

An improved structural and process quality could be demonstrated 13 years after certification of the first German prostate cancer center. The question of optimization of the functional quality by establishing organ cancer centers arises.

A critical benefit-risk analysis of organ cancer centers was carried out to evaluate an improved quality of results.

Based on published results from individual centers and the individual annual reports of the German Cancer Society (DKG), the data for evaluating the quality of results were checked. For the issuing of certificates, the focus is on quality indicators for oncological surgery. The functional quality of results is assessed exclusively by a questionnaire-based survey.

An improvement in the quality of functional results after radical prostatectomy has not yet been demonstrated. The functional quality features of urinary continence and erectile function that are essential for the quality of life and patient satisfaction are only insufficiently assessed due to the lack of objective measuring instruments and are not relevant for certification. There is no reliable evidence for improved overall survival, reduction in tumor-specific mortality, and optimization of functional results in certified centers.

The relationship between certification and excellence cannot be proven without individual consideration of a surgeon-specific pentafecta analysis. For this reason, certification-relevant surgeon-related quality assurance is recommended.