Survival of primary brain tumor patients according to treatment in certified oncologic centers.

BACKGROUND: Brain tumors are mostly aggressive tumors requiring guideline-based interdisciplinary treatment. Certification as a cancer center requires numerous structural efforts and high costs. AIMS: The aim of this study was to explore if treatment in certified cancer centers in Germany leads to better survival rates among patients with brain tumors. METHODS: We compared overall survival between brain tumor patients treated in certified cancer centers and non-certified hospitals in a cohort study with 62,735 patients documented in the Statutory Health Insurance (SHI) and 5196 patients documented in the Clinical Cancer Registries (CCR) in Germany. RESULTS: Most patients were not treated in neuro-oncological centers (91·9% for SHI-, 73·1% for CCR-data). Overall survival was significantly improved for patients treated in certified neuro-oncologic cancer centers compared to patients treated in non-certified hospitals for both SHI and CCR-data in multivariable adjusted Cox regression analyses (HR for SHI-data=0·93, 95% CI=0·86-1·00; HR for CCR-data=0·84, 95% CI=0·76-0·93). Subgroup analyses identified patient groups, such as older patients or patients with higher WHO grade of glioma, to particularly benefit from treatment within centers. The association increased with hospital size and duration of certification. CONCLUSION: The findings of our study suggest that survival of brain tumor patients is associated with treatment in certified neuro-oncological cancer centers.