Optimized surgical treatment and study management for oncology patients in East Saxony (MISSION4Sax): study protocol of a multicentre pilot study.

PURPOSE: MISSION4Sax aims to develop and pilot new concepts for cross-sectoral oncological care, data integration and networking between maximum care centres and rural practitioners in medical underserved, enabling access to guideline-based therapy, innovative surgery, and clinical trials. METHODS: This pilot project is an exploratory multicentre, prospective longitudinal study. It assesses the feasibility, acceptability, implementation and data-quality aspects of the proposed care model and study infrastructure, rather than to determine the effectiveness or causal impact of the interventions. It implements an interdisciplinary, cross-sectoral care model centred on a regional surgical indication tumour board at the National Center for Tumor Diseases (NCT) Dresden. Evidence-based, standardised patient care pathways are developed and piloted across three regional hospitals and two oncology practices. A database using the infrastructure of the NCT Core Unit "Registry Trial Platform", targeted training programmes and "Flying Data Nurses" support coordination, data flow and communication. Patient-reported outcomes complement the clinical data. Routinely collected health insurance data will be used exclusively as external reference data for a descriptive comparison with the MISSION4Sax cohort; no individual-level data linkage will be performed. A mixed-methods process evaluation will be performed alongside the project. EXPECTED OUTCOMES: The study will assess feasibility in routine care and explore access to specialised care, waiting times, coordination, pathway adherence, and clinical and patient-reported outcomes. CONCLUSION: Strengthening cancer care infrastructure, interdisciplinary cooperation, and digital systems may support equitable access to high-value care in rural regions. The proposed tumour board, patient pathways, and trained staff may improve care quality and collaboration across sectors. TRIAL REGISTRATION: DRKS00036134 (registration date: 30 June 2025).