Evidence-based quality indicators of soft tissue sarcomas in Germany 2015-2021: An analysis of the German Cancer...

Empirical evidence shows that treatment of adult soft tissue sarcoma (STS) according to clinical guidelines has a survival benefit for patients. In 2021, the first evidence-based guidelines for STS were published in Germany including 14 measurable quality indicators (QIs). This paper examines the quality of care of STS in Germany across all treatment institutions prior to the publication of the clinical guideline using the QIs. A comprehensive population-based cohort of 20,922 sarcoma patients from 11 of 16 federal states, diagnosed between 2015 and 2021 was extracted from the cancer registry data using the ICD-O-3-codes for topography and histological subtype. The QI measurements are based on the calculation rules of a group of experts. Annual percentage changes (APCs) were calculated to identify trends over time. QI 1 (Pre-therapeutic presentation in the tumor board (initial diagnosis of STS)) increased from 9 % to 24 %. QI 7 (R0 resection for STS) showed a stable rate of over 80 %. For QI 8 (hysterectomy without morcellation for sarcoma confined to the uterus), the rate was 82 % in 2015 and rose significantly until 2017 to 94 %. QI 12 (First-line chemotherapy for STS without GIST) remained at the same level as the overall value of 79 %. For QI 14 (Postoperative mortality in retroperitoneal sarcoma), the value for the entire period was 1.4 %. The extensive database enables QI analysis for sarcoma care. Improvements in defined QIs confirm progress, while unmet targets are identifiable. Using cancer-registry data ensures comprehensive coverage of all institutions treating sarcoma patients, extending beyond accredited sarcoma centers. Results may serve as baseline values for future evaluations of improvements in patient care following implementation of the S3 guideline.