@article{OHLMANN2024328,

title = {P260 Real-world data on treatment patterns and guideline adherence in patients with locally advanced and metastatic urothelial bladder cancer (la/mUC) in Germany},

author = {C. H. Ohlmann and G. Niegisch and M. Kerkmann and L. Holtmann and P. Hammerer and V. Gr\"{u}nwald and P. Ivanyi and M. Jahnen and D. Barski and D. Marghawal and M. J. Schnabel and J. Graff and A. Neisius and F. Thomas and F. Zengerling and A. Hamza and Z. Pinter and D. Sikic and H-J. Sommerfeld and A. Blana},

url = {https://www.sciencedirect.com/science/article/pii/S2666168324013788},

doi = {https://doi.org/10.1016/S2666-1683(24)01378-8},

issn = {2666-1683},

year  = {2024},

date = {2024-11-07},

urldate = {2024-11-07},

journal = {European Urology Open Science},

volume = {69},

pages = {328-329},

abstract = {Introduction \& Objectives: 

Recent and detailed data regarding treatment quality of patients (pts) with la/mUC in clinical routine are largely unknown for Germany. During the study period national and international guidelines recommended platinum-based chemotherapy (PBC) as the standard treatment for la (T4b or ≥N2) or mUC (M1), with cisplatin being more effective than carboplatin. Immune-checkpoint inhibitors (ICI) were recommended for PD-L1+ patients ineligible for platinum-based treatment (pt-) or as 2nd line treatment (2L), and antibody-drug conjugates (ADC) were an option for subsequent lines of treatment. The aim of the study was to obtain representative data on clinical routine

treatment and guideline adherence (GLAD) in Germany.

Materials \& Methods: 

This study was a nationwide retrospective data collection in hospitals and office-based physicians conducted by the working groups Urological Oncology (AUO), Medical Oncology (AIO) and the Interdisciplinary Working Group Bladder Cancer (IABC) of the German Cancer Society (DKG). Data on the treatment of pts with a newly diagnosed la/mUC in Q4/2022 or Q1/2023 were collected from 98 centers. Galsky-criteria on renal function, ECOG and relevant comorbidities were used to asses platinum-eligibility with GFR \> 60 mL/min defined as cisplatin-eligible (cp+), GFR 30-60 mL/min or ECOG 2 as platinum-eligible (pt+) and GFR \< 30mL/min, ECOG \> 2 and

comorbidities \> Grade 2 as pt-. Kaplan-Meier estimates were used for overall survival (OS). 

Results: 

Data from 459 pts were analyzed (57 la/402 mUC). Median age was 70 years (IQR 64-78), performance status was ECOG 0/1 in 72% and 2+ in 28%. 203 pts (44%) were cp+, 162 (35%) pt+, 76 (17%) pt- and 18 (4%) not classifiable. PD-L1 status was tested in 58% of pts (cp+ 53%, pt+ 61%, pt- 65%). 63% of tested pts were PD-L1+. 346 pts (75%) received systemic treatment (85% of cp+, 66% of pt+ and 67% of pt-). 239 pts (52%) received PBC, 96 ICI (21%) and 10 other chemotherapy (2%). 60% of cp+ received cisPBC, 3% carboPBC, 20% ICI, 2% other, 16% no treatment), 41% of pt+ received PBC (26% cisPBC and 15% carboPBC), 23% ICI, 2% other and 34% no treatment. 32% of

pt- received cisPBC, 13% carboPBC, 18% ICI, 5% other and 32% no treatment. Overall 29% of pts with PBC received maintenance with avelumab. 70 pts (15%) were systemically pre-treated and 116 pts (25%) received 2L treatment, 61% ICI, 28% ADC, 6% PBC, and 4% vinflunine. 10-month OS was 75% (95% CI 70-80%) in systemically treated pts and 46% (95% CI 36-58%) in untreated pts (p\<0.001).

Conclusions: 

The treatment recommendations regarding platinum eligibility are insufficiently implemented in clinical routine. ICI is used in pt- but also in cp+ and pt+. PD-L1 testing was not performed in 35% of the pt- population. Altogether, there is a considerable proportion of untreated patients.},

note = {16th European Multidisciplinary Congress on Urological Cancers 7-10 November 2024, Lisbon, Portugal},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN647,

title = {Qualit\"{a}tssicherungsinitiative der AGO Kommission Mamma zur Therapie des Mammakarzinoms in Deutschland 2024 (QS-Mamma)},

author = {Christian Jackisch and Patrik Lindenmaier and Andreas Jaeger},

url = {https://doi.org/10.1007/s12312-024-01390-1},

doi = {10.1007/s12312-024-01390-1},

issn = {2190-9784},

year  = {2024},

date = {2024-10-22},

urldate = {2024-01-01},

journal = {Forum},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN645,

title = {Treatment of patients with metastatic or relapsed cervical cancer: Results from a quality assurance program of the AGO Study Group},

author = {Dominik Denschlag and Bastian Czogalla and Florian Heitz and Markus Kerkmann and L. C. Fangmann and Philip Klecker and Frederik St\"{u}bs and Linn Woelber and Julia Radosa and Pia Lodde and Stephan Seitz and Christian George and P. Mach and A. Fink and Davit Bokhua and B. Lampe and F. Hemptenmacher and Verena Friebe and Markus Fleisch and Philipp Harter},

issn = {0016-5751 1438-8804},

year  = {2024},

date = {2024-10-17},

urldate = {2024-10-17},

journal = {Geburtshilfe Frauenheilkd},

volume = {84},

number = {10},

abstract = {Background: Real-world data on treatment patterns and outcomes in recurrent or metastatic cervical cancer (r/mCC) are lacking. Methods: Within this retrospective analysis patients with r/mCC diagnosed between 2018 and 2022 were identified from medical records of 31 gynecologic cancer centers in Germany. Patient demographic and clinical characteristics, treatment patterns, and clinical outcomes were assessed descriptively. Progression-free- (PFS) and overall survival (OS) was calculated using Kaplan-Meier analysis. Results: A total of 503 eligible patients (median age 55 years) were analyzed and received systemic treatment for r/mCC. 276/503 patients (55%) received first line (1L) chemotherapy (platinum combination: 247/276; 79%) followed by targeted maintenance therapy with Bevacizumab (177/247; 72%), immunotherapy (19/247; 8%), or both combined (50/247; 20%). 111/503 (22%) received chemotherapy only (platinum combination: 64/111; 58%, platinum mono: 35/111; 31%, or platinum-free: 12/111; 11%), and 110/503 (22%) did not receive any systemic treatment. For these subgroups after a median follow-up of 16 months, the PFS was 12 months (95%-CI 11-14), 8.8 months (95%-CI 7.1-11), and 3 months (95%-CI 2.3-4.8), and OS was 25 months (95%-CI 21-31), 17 months (95%-CI 14-22), and 3.6 months (95%-CI 2.8-5.3), respectively. 176/283 (62%) patients who developed progressive disease (PD) were treated with second line (2L) therapy. Conclusion: Only half of the patients with r/mCC were treated 1L with platinum-combination therapy including maintenance therapy. Moreover, 22% at initial diagnosis and 38% at PD were not treated with systemic therapy at all. This might reflect poor general performance status, patients preference, and/or lack of effective therapies especially in 2L treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN645,

title = {Real World Qualit\"{a}tssicherungsdaten beim fr\"{u}hen Ovarialkarzinom: Ergebnisse der QS-Ovar},

author = {P. Wimberger and J. Pfisterer and A. Bois and F. Hilpert and M. Kerkmann and J. Sehouli and S. Mahner and N. Gregorio and L. Hanker and F. Heitz and F. Marm\'{e} and L. W\"{o}lber and L. Holtmann and G. Elser and P. Harter},

url = {http://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0044-1791072},

doi = {10.1055/s-0044-1791072},

issn = {0016-5751 1438-8804},

year  = {2024},

date = {2024-10-16},

urldate = {2024-01-01},

journal = {Geburtshilfe Frauenheilkd},

volume = {84},

number = {10},

pages = {463},

abstract = {Zielsetzung: QS-Ovar dokumentierte 2004/2008/2012/2016 und 2021 alle Ovarialkarzinomerstdiagnosen (OC) im 3. Quartal. Diese repr\"{a}sentative Datenerhebung evaluiert Therapiestandardumsetzung und Outcome f\"{u}r FIGO I Ovarialkarzinome.

Materialien/Methoden: Die Therapiequalit\"{a}t orientierte sich an g\"{u}ltigen Therapiestandards und Leitlinien. OP-Qualit\"{a}t wurde als „optimal“ (OP+ maximal 1 OP-Parameter fehlend), vs. „suboptimal“ (OP-) kategorisiert; analog „optimale“ Systemtherapie (CT+) und „suboptimal“ (CT-).

Ergebnisse: 19,3% (n=832) hatten ein FIGO I OC, 47,4% FIGO IA, 47,6% FIGO IC; 35,7% waren high-grade ser\"{o}s. Der operative Standard erh\"{o}hte sich von 21,1% (2004) auf 53,0% (2012). OP-Qualit\"{a}t ist seither unver\"{a}ndert mit 53,8% (2021), ebenso das OP+-Kollektiv mit 74,2%. Die OP+/CT+-Subgruppe hat sich 2021 verringert mit 62,9% versus 69,2% (2016). Der Anteil mit ≥25 resezierten Lymphkonten war 2021 67,6% bei high-grade ser\"{o}sen und 46,2% bei den low-grade ser\"{o}sen Karzinomen. Bei low-grade endometrioiden (33,3%) und muzin\"{o}sen (35,7%) Karzinomen wurde 2021 seltener lymphonodektomiert. Multivariabel zeigte sich eine schlechtere Prognose \"{u}ber 75 Jahre, ECOG 2+, FIGO IC, Komorbidit\"{a}ten, sowie ein OS-Benefit f\"{u}r die OP+/CT+-Subgruppe. OS ist signifikant verl\"{a}ngert: 93% nach 48 Monaten f\"{u}r OP+/CT+-Subgruppe versus 64% f\"{u}r OP-/CT--Subgruppe (HR 0,17, p\<0,001). Bei OP+ war das OS nach 48 Monaten 91% versus 76% bei OP- (HR 0,35, p\<0,001) und bei optimaler adjuvanter Therapie 91% versus 68% nach suboptimaler Systemtherapie (HR 0,26, p\<0,001). Eine Therapiemodalit\"{a}t kann die andere nicht ersetzen. Das Erkrankungsfreie \"{U}berleben war nach 48 Monaten 86% bei OP+/CT+, 78% bei OP-/CT+, 68% bei OP+/CT- und 57% bei OP-/CT- (p\<0,001).

Zusammenfassung: Die Therapiequalit\"{a}t hat sich 2021 nicht verbessert, wobei eine leitliniengerechte Therapie zur Prognoseverbesserung dringend zu fordern ist.

},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN642,

title = {725P Treatment of patients with metastatic or relapsed cervical cancer: Results from a quality assurance program of the AGO Study Group},

author = {D. Denschlag and F. Heitz and L. C. Fangmann and M. Kerkmann and P. H. Klecker and L. Woelber and P. Mach and A. Fink and D. Bokhua and N. Gregorio and F. Hemptenmacher and V. Friebe and P. Wimberger and A. Jaeger and S. Mittelstadt and M. Kalder and W. Schr\"{o}der and H. Bronger and P. Harter and B. Czogalla},

url = {https://doi.org/10.1016/j.annonc.2024.08.787},

doi = {10.1016/j.annonc.2024.08.787},

issn = {0923-7534},

year  = {2024},

date = {2024-09-14},

urldate = {2024-01-01},

journal = {Annals of Oncology},

volume = {35},

pages = {S553-S554},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN636,

title = {Surgical Treatment of Patients with Endometriosis in the Certified Endometriosis Centers of the DACH Region \textendash A Subanalysis of the Quality Assurance Study QS ENDO pilot},

author = {Felix Zeppernick and Magdalena Zeppernick and Monika Martina W\"{o}lfler and Elisabeth Janschek and Laura Holtmann and Sebastian Bornemann and Frank Oehmke and Darius Salehin and Chi Mi Scheible and Iris Brandes and Sigrid Vingerhagen-Pethick and Claus-Peter Cornelius and Alexander Boosz and Bernhard Kr\"{a}mer and Martin Sillem and J\"{o}rg Keckstein and Karl-Werner Schweppe and Ivo Meinhold-Heerlein and Q. S. Endo Working Group of the Endometriosis Research Foundation the},

url = {http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2324-3778},

doi = {10.1055/a-2324-3778},

issn = {0016-5751 1438-8804},

year  = {2024},

date = {2024-07-09},

urldate = {2024-07-09},

journal = {Geburtshilfe Frauenheilkd},

volume = {84},

number = {07},

pages = {646-655},

abstract = { Introduction After puberty, at least 10% of all women and girls suffer from endometriosis. Surgery is useful for both the diagnosis and therapy. To date, quality indicators for the surgical treatment of endometriosis are lacking. QS ENDO aims to record the quality of care provided in the DACH region and to introduce quality indicators for the diagnosis and treatment of endometriosis. In the first phase of the study, QS ENDO real, the reality of care was recorded using a questionnaire. The second phase, QS ENDO pilot, investigated the treatment of patients who underwent surgery in certified endometriosis centers in a defined time-period.



Material and Methods The surgical data of 10 patients from each of the 44 endometriosis centers in the DACH region was recorded using an online tool. Collected data included the approach used, the endometriosis phenotype, a description of the surgical site, resection status, histological confirmation, the use of a classification, and any complications. All operations were carried out in October 2016 as the defined time-period. The surgical approaches used were compared with the recommendations in the current guidelines.



Results The data of 435 patients with a median age of 34 years were evaluated. 315 (72.4%) were nulliparous. 120 patients had given birth to at least one child and 42.5% (51) of them had delivered their child by caesarean section. About 50% of all patients also had deep infiltrating endometriosis in addition to ovarian endometriosis, and the median NAS score was 7.5. With regards to the surgical treatment, endometriomas were completely resected in 81% (94) of patients. 87.3% of patients underwent resection of peritoneal endometriosis. Forty-one patients had a hysterectomy, with a total hysterectomy carried out in 26 (63.4%) and a supracervical hysterectomy in 15 (36.6%) patients. Of the 59 patients with bowel endometriosis, half had segmental resection and half had shaving of the anterior rectal wall. Complications requiring revision occurred in 0.9% of cases.



Conclusion The surgical procedures carried out in the certified endometriosis centers of the DACH region are largely in line with the recommendations for appropriate surgical approaches in the current standard guidelines.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {48MO - Treatment and outcome of elderly patients with advanced ovarian cancer in Germany: QS-OVAR of the AGO Study Group},

author = {Felix Hilpert and Jacobus Pfisterer and Andreas Du Bois and Sven Mahner and Frederik Marm\'{e} and Markus Kerkmann and Jalid Sehouli and Nikolaus de Gregorio and Lars Ch Hanker and Florian Heitz and Linn Lena Woelber and Laura Holtmann and Gabriele Elser and Philipp Harter },

url = {https://oncologypro.esmo.org/meeting-resources/esmo-gynaecological-cancers-congress-2024/treatment-and-outcome-of-elderly-patients-with-advanced-ovarian-cancer-in-germany-qs-ovar-of-the-ago-study-group},

doi = {10.1016/j.esmoop.2024.103555},

year  = {2024},

date = {2024-06-21},

urldate = {2024-06-21},

journal = {ESMO Open},

volume = {9},

number = {(suppl_5)},

pages = {1-19},

abstract = {Background



Treatment of elderly ovarian cancer (OC) patients follows a fine line between risk and benefit and is often below recommended standards. The German quality assurance program QS Ovar provides a deep and representative insight into the treatment of elderly OC patients and their outcome during the past decade.

Methods



All German hospitals with OC patients were asked to document patient characteristics, treatment and outcome of all patients with first diagnosis in the third quarter of 2012, 2016 and 2021, respectively. This analysis is focusing on patients with age =/\>75 years and OC FIGO III/IV.

Results



A total of 1951 OC patients were analyzed, 539 (28%) =/\> 75 years and 1412 (72%) \< 75 years. Elderly and younger showed significant differences in ECOG (ECOG =/\> 2: 39% vs 17%), surgical outcome (residual tumor (RT) = 0 cm: 32 vs 54%; RT\> 1cm: 37% vs. 22%), chemotherapy (CTX) use (platinum/taxane (TC) + maintenance (M) (31 vs 66%), Carboplatin-mono (C) (15 vs 3%) and survival (PFS: 13 vs 22, HR 1.7 and OS: 21 vs 44 months, HR 2.29). Among elderly, 15% received no surgery and 34% no CTX. Optimal treatment in terms of surgery and/or CTX translated into improved survival and was influenced by numerical age, ECOG, comorbidities and FIGO stage. Subgroup analysis showed no benefit for TC +/-M vs C+/-M in elderly with no RT after surgery (PFS 29 vs 32 months, p= 0.77; OS 52 vs 39 months, p= 0.23) but in pts with RT \> 0 cm (PFS 16 vs 10 months, p=0.065; OS 28 vs 20 months, p= 0.032). Incomplete cytoreductive surgery without postoperative CTX (n= 102 (19%)) had no beneficial effect on survival. Median PFS and OS for elderly patients who received no or incomplete (TR\> 0cm) surgery without CTX was 3.2 and 2.9 months, resp. 3.2 and 3.4 months, but with subsequent CTX 12 and 14 months, resp. 17 and 26 months (p\<0.001).

Conclusions



Treatment decisions in elderly are critical. Treatment patterns offer a potential for de-escalation. The triage for or against surgery should be done with respect to subsequent CTX, whose omission seems to be the worst prognostic factor among the therapeutic modalities. Survival of OC patients with tumor but without CTX was 3 months.

Legal entity responsible for the study



AGO Organkommission Ovar and the AGO Study Group.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {72P - Real-world data of treatment and outcome of patients with advanced ovarian cancer (AOC) in Germany: QS OVAR of the AGO Study Group},

author = {Philipp Harter and Jacobus Pfisterer and Andreas Du Bois and Sven Mahner and Frederik Marm\'{e} and Markus Kerkmann and Jalid Sehouli and Nikolaus de Gregorio and Lars Ch Hanker and Florian Heitz and Linn Lena Woelber and Laura Holtmann and Gabriele Elser and Felix Hilpert},

url = {https://oncologypro.esmo.org/meeting-resources/esmo-gynaecological-cancers-congress-2024/real-world-data-of-treatment-and-outcome-of-patients-with-advanced-ovarian-cancer-aoc-in-germany-qs-ovar-of-the-ago-study-group},

doi = {10.1016/j.esmoop.2024.103579},

year  = {2024},

date = {2024-06-20},

urldate = {2024-06-20},

journal = {ESMO Open},

volume = {9},

number = {(suppl_5)},

pages = {1-19},

abstract = {Background

Recent and detailed data regarding treatment quality of patients with AOC in the era of precision medicine are largely unknown in Germany.

Methods

All German hospitals treating patients with ovarian cancer were asked to document prospectively all patients with first diagnosis in the third quarter in 2021. Details of tumor, treatment and outcome were documented. Here, we report tumor and treatment characteristics.

Results

In total, 598 pts with AOC were documented. The primary debulking surgery (PDS) rate was 429/598 (71.7%) and complete resection (CR) at PDS was achieved in 252/429 pts (58.7%), 92/598 pts (15.4%) had interval debulking surgery and 77/598 pts (12.9%) had no surgery. In total, 514/598 pts (86.0%) were treated with chemotherapy. 490/514 (95.3%) received carboplatin/paclitaxel and 401/514 (78.0%) received additional maintenance therapy. 470 patients had high-grade histology and were treated with chemotherapy. The BRCA testing rate in this population was 390/470 (83.0%) and HRD testing rate was 245/470 (52.1%). In total, 90 of 390 tested patients were BRCA-positive (23.1%) and 101/245 patients were HR deficient (41.2%). BRCA+ patients were treated with bevacizumab/PARPi in 58.9%, PARPi single agent in 31.1%. The rates in BRCAwt/HRd were 62.9% and 12.0%, respectively. HRp tumors were treated mainly with bevacizumab (70.8%) or by PARPi in 15.4%. BRCAwt/HRD unknown patients were treated mainly with bevacizumab (35.8%) or PARPi (30.5%). Patients who were not tested (15.8%) were mainly treated with chemotherapy only (58.0%) and bevacizumab (35.8%). The rates of chemo only patients in the other subgroups varied between 2.2% and 22.1%.

Conclusions

Most patients in Germany with AOC are treated with primary surgery followed by chemotherapy including a maintenance therapy. The rates of BRCA and HRD testing are high and PARPi in primary OC are often used already after a short period after approval in Germany.

Legal entity responsible for the study

AGO Research GmbH (AGO Study Group).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN634,

title = {Leitlinienadh\"{a}renz bei An\"{a}miemanagement, Neutropenieprophylaxe, Osteoprotektion, Immunglobulinsubstitution und Antiemese},

author = {Hartmut Link and Laura Holtmann and Petra Ortner and Ingo Diel and Carsten- H. Ohlmann and Karin Jordan and Petra Feyer and Markus Detzner and Markus Kerkmann},

url = {https://doi.org/10.1007/s00761-024-01550-x},

doi = {10.1007/s00761-024-01550-x},

issn = {2731-7234},

year  = {2024},

date = {2024-06-18},

urldate = {2024-06-18},

journal = {Die Onkologie},

abstract = {Die supportive Therapie ist essenziell f\"{u}r den Erfolg der onkologischen Behandlung. Evidenzbasierte Leitlinien (LL) empfehlen die besten M\"{o}glichkeiten der Supportivtherapie. Onkologische LL sind evidenzbasierte Behandlungsempfehlungen in der medizinischen Versorgung. Wirksame Strategien zur Umsetzung und Einhaltung von LL spielen eine entscheidende Rolle bei der Optimierung der onkologischen Versorgung.



Mit 6 repr\"{a}sentativen retrospektiven epidemiologischen Studien in Deutschland wurde seit 2013 die Adh\"{a}renz an die S3-LL Supportivtherapie der Deutschen Krebsgesellschaft, der DGHO, ESMO, ASCO und ggf. anderer relevanter Fachgesellschaften untersucht.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {BMI as risk-factor in early breast cancer \textendash data of 10 years AGO QS-Mamma},

author = {Christian Jackisch and Andreas Jaeger and Patrik Lindenmaier},

url = {https://eref.thieme.de/Z9PK7VP},

doi = {10.1055/s-0044-1786096},

year  = {2024},

date = {2024-06-06},

urldate = {2024-06-06},

journal = {Senologie},

volume = {21},

issue = {02},

pages = {e1\textendashe40},

abstract = {Zielsetzung: High BMI is associated with higher risk of breast cancer and poor prognosis. This could be due to tumor-external factors as well as tumor characteristics. However, the characteristics associated with high BMI remain underexposed. Therefore, we evaluated patients with EBC over ten years in correlation with their BMI.

Material: As part of the QS-Mamma, data from n = 4.554 patients were collected over 6 cohorts (10 years).

Methoden: BMI was correlated with age, comorbidity, general condition, hormone receptor status, grading, tumor size and nodal status. Significance level was calculated as 0.05.

Ergebnisse: BMI is largely stable over time. Younger patients tend to have a lower BMI. BMI \> 25 peaks among 60- to 70-year-olds. 78.8 % of patients with BMI \> 35 present with HR + EBC, 73.4 % with BMI 30-35. 70.0 % of patients with

BMI \< 30 present with HR + EBC (p \< 0.001). Patients with high BMI have significantly more comorbidities and a worse general condition. Small tumors T1 are less frequent with BMI \< 30, large tumors slightly more frequent. Grading, no-

dal status and Ki-67 show no significant differences according to BMI. There is no difference between pre- and postmenopausal patients.

Zusammenfassung: The data from the QS-Mamma show a correlation between BMI and hormone receptor status. The prognostic value of BMI remains controversial depending on the subtype. The available data raises the question

of whether a high BMI not only influences the general well-being of the patient, but also influences the tumor environment. This would require a new, sharper look at BMI as a risk factor},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {A decade AGO QS-Mamma \textendash Guideline-based treatment of early breast cancer on its way to precision therapy},

author = {Christian Jackisch and Andreas Jaeger and Patrik Lindenmaier},

url = {https://eref.thieme.de/Z9PK7VQ},

doi = {10.1055/s-0044-1786097},

year  = {2024},

date = {2024-06-06},

urldate = {2024-06-06},

journal = {Senologie},

volume = {21},

issue = {02},

pages = {e1\textendashe40},

abstract = {Zielsetzung: Individualization of cancer treatment in EBC requires constant optimization via guidelines. The AGO QS-Mamma provides insight in guideline adherence in real world practice. We evaluated 10 years of QS-Mamma data to

identify gaps and trends in guideline implementation. 

Material und Methoden: QS-Mamma is a retrospective sample survey providing a representative overview of the treatment landscape for breast cancer in Germany. The last six cohorts were analyzed, corresponding to a period of 10

years. Across all cohorts, an average of n = 264 centers documented a total of n = 4577 patients with early breast cancer.

Ergebnisse: Identification and documentation of key tumor characteristics have increased over time. Testing for BRCA mutations in triple-negative patients increased from 30.2 % at the start of survey in 2016 to 71.8 % in 2022. Breast

conserving surgery has been standard since the start of data collection; the choice of surgical procedure depends primarily on tumor size and node status. Axillary Intervention differs according to nodal involvement, while the number

of lymph nodes removed in ALND decreases. NAST is established. Anthracycline administration is decreasing, especially in the adjuvant setting. Platinum-containing CTx in TNBC has risen continuously, corresponding to AGO recommendations. Dual HER2 blockade is established. Changes in guidelines are reflected in real-world data.

Zusammenfassung: Guideline adherence in breast cancer care is high, with new treatments and diagnostic possibilities promptly implemented by physicians. Escalation and de-escalation of treatment depends on individual tumor

characteristics and risk factors. Guidelines should be flanked by real-world evidence to ensure and test their impact},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN631,

title = {Anemia diagnosis and therapy in malignant diseases: implementation of guidelines\textemdasha representative study},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann and Markus Detzner},

url = {https://doi.org/10.1007/s00520-023-08267-4},

doi = {10.1007/s00520-023-08267-4},

issn = {1433-7339},

year  = {2024},

date = {2024-01-19},

urldate = {2024-01-19},

journal = {Supportive Care in Cancer},

volume = {32},

number = {2},

pages = {113},

abstract = {Purpose: Anemia in cancer should be diagnosed and treated according to guideline recommendations. The implementation of ESMO and German guidelines and their effect on anemia correction was analyzed. 

Methods: This retrospective epidemiological study, representative for Germany, analyzed data on anemia management of cancer patients with anemia ≥ grade 2. The Guideline Adherence Score (GLAD) for diagnosis (GLAD-D) and therapy (GLAD-T) was defined as follows: 2 points for complete, 1 point for partial, 0 point for no adherence. 

Results: Data were analyzed for 1046 patients. Hb levels at diagnosis of anemia were 8-10 g/dL in 899 (85.9%) patients, 7-8 g/dL in 92 (8.7%), and \< 7 g/dL (5.0%) in 52. Transferrin saturation was determined in 19% of patients. Four hundred fifty-six patients received RBC (43.6%), 198 (18.9%) iron replacement, 106 (10.1%) ESA, and 60 (5.7%) vitamin B12 replacement. 60.6% of patients receiving iron replacement were treated intravenously and 39.4% were treated orally. Two hundred eighty-eight (36.6%) of 785 patients receiving transfusions had no guideline-directed indication. GLAD-D was 2 in 310 patients (29.6%), 1 in 168 (16.1%), and 0 in 568 (54.3%). GLAD-T was 2 in 270 patients (25.8%), 1 in 320 patients (30.6%), and 0 in 456 patients (43.6%). Higher GLAD-D significantly correlated with higher GLAD-T (τB = 0.176, p \< 0.001). GLAD-T 2 was significantly associated with greater Hb increase than GLAD-T 0/1 (p \< 0.001) at 28 days (10.2 vs. 9.7 g/ dL) and at 2 months (10.4 vs. 9.9 g/dL). 

Conclusions: Anemia assessment is inadequate, transfusion rates too high, and iron and ESA therapy too infrequent.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN630,

title = {Qualit\"{a}tssicherung zur Diagnose und Therapie von Harnblasenkarzinomen 2023 (QS Harnblase)},

author = {Carsten-Henning Ohlmann and Peter Hammerer and Viktor Gr\"{u}nwald and G\"{u}nter Niegisch and Markus Kerkmann and Laura Holtmann and Heidrun Rexer},

url = {https://doi.org/10.1007/s12312-023-01273-x

https://www.mmf-research.de/forum-qs-harnblase-2023/},

doi = {10.1007/s12312-023-01273-x},

issn = {2190-9784},

year  = {2023},

date = {2023-12-15},

urldate = {2023-12-15},

journal = {Forum},

abstract = {In Deutschland erkranken j\"{a}hrlich fast 18.000 Menschen neu an Blasenkrebs; M\"{a}nner sind etwa dreimal so h\"{a}ufig betroffen wie Frauen. Damit ist das Harnblasenkarzinom die vierth\"{a}ufigste b\"{o}sartige Erkrankung bei M\"{a}nnern und die vierzehnth\"{a}ufigste bei Frauen. Um detaillierte Einblicke in den klinischen Alltag und die Umsetzung der Therapieempfehlungen der Leitlinien in Deutschland zu erhalten sowie m\"{o}gliche regionale und strukturelle Unterschiede zu identifizieren, wurde im Jahr 2020 von den Arbeitsgemeinschaften Urologische Onkologie (AUO) und Internistische Onkologie (AIO) in der Deutschen Krebsgesellschaft (DKG) die Qualit\"{a}tssicherungsinitiative Harnblase ins Leben gerufen, die auch von der Interdisziplin\"{a}ren Arbeitsgruppe BlasenCarcinom (IABC) unterst\"{u}tzt wird. Ziel der Initiative ist es, in regelm\"{a}\ssigen Abst\"{a}nden repr\"{a}sentativ die Qualit\"{a}t der Therapie beim Harnblasenkarzinomin Deutschland zu erfassen, zu analysieren und daraus Erkenntnisse zu gewinnen, die in Ma\ssnahmen zur Qualit\"{a}tssteigerungumgesetzt werden k\"{o}nnen.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN617,

title = {QS ENDO Pilot \textendash A Study by the Stiftung Endometrioseforschung (SEF) on the Quality of Care Provided to Patients with Endometriosis in Certified Endometriosis Centers in the DACH Region},

author = {Ivo Meinhold-Heerlein and Magdalena Zeppernick and Monika Martina W\"{o}lfler and Elisabeth Janschek and Sebastian Bornemann and Laura Holtmann and Frank Oehmke and Darius Salehin and Chi Mi Scheible and Iris Brandes and Sigrid Vingerhagen-Pethick and Claus-Peter Cornelius and Alexander Boosz and Bernhard Kr\"{a}mer and Martin Sillem and B\"{u}hler† Klaus and J\"{o}rg Keckstein and Karl-Werner Schweppe and Felix Zeppernick and A. G. Q. S. Endo of the Stiftung Endometrioseforschung the},

url = {http://www.thieme-connect.de/products/ejournals/abstract/10.1055/a-2061-6845},

doi = {10.1055/a-2061-6845},

issn = {0016-5751 1438-8804},

year  = {2023},

date = {2023-05-25},

urldate = {2023-05-25},

journal = {Geburtshilfe Frauenheilkd},

number = {83},

pages = {835-842},

abstract = {Introduction: Endometriosis significantly reduces patientsʼ quality of life and is additionally a burden on healthcare and social security systems. There are currently no quality indicators for the treatment of endometriosis. The care of patients with endometriosis must be considered inadequate. QS ENDO aims to record the quality of care available in the DACH region and to introduce quality indicators for the diagnosis and treatment of endometriosis as part of providing quality assurance in endometriosis care. The first phase, QS ENDO Real, recorded the reality of current care using a questionnaire. The second phase, QS ENDO Pilot, investigated the treatment of 435 patients who underwent surgical treatment within a defined one month period in certified endometriosis centers.



Material and Methods: An online tool was used to gather information about 9 points which covered both prior patient history and the process of clinical diagnosis. Surgery reports were reviewed to obtain information about the surgical approach, the investigated sites, findings of any histological examinations, the use of classification systems, and information about resection status.



Results: 85.3% of patients were asked all 4 questions about their prior medical history. All 5 diagnostic steps were carried out in 34.5% of patients. The 3 areas needed to describe potential sites of disease were recorded in 67.1% of patients. Samples for histological examination were taken in 84.1% of patients. The endometriosis stage was classified in 94.7% of surgeries. A combination of the rASRM and the ENZIAN classifications, which is needed for complex cases, was used in 46.1% of patients. Complete resection was achieved in 81.6% of surgical procedures.



Conclusion For the first time, the quality of care in certified endometriosis centers has been recorded using QS ENDO Pilot. Despite the high certification standards, a substantial number of required indicators were omitted.



Key words

endometriosis - quality assurance - reality of current care - healthcare research},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Wimbergerijgc-2022-004233,

title = {Quality of therapy in early ovarian cancer: results of the quality assurance program of the AGO Study Group},

author = {Pauline Wimberger and Jacobus Pfisterer and Andreas Bois and Felix Hilpert and Markus Kerkmann and Jalid Sehouli and Sven Mahner and Nikolaus Gregorio and Lars Hanker and Florian Heitz and Frederik Marm\'{e} and Linn Woelber and Laura Holtmann and Gabriele Elser and Philipp Harter},

url = {https://ijgc.bmj.com/content/early/2023/03/30/ijgc-2022-004233},

doi = {10.1136/ijgc-2022-004233},

issn = {1048-891X},

year  = {2023},

date = {2023-03-31},

urldate = {2023-03-31},

journal = {International Journal of Gynecologic Cancer},

volume = {33},

number = {1083-1089},

publisher = {BMJ Specialist Journals},

abstract = {Objective The quality assurance program for ovarian cancer (QS-OVAR) evaluates the implementation of treatment standards and impact on survival for International Federation of Gynecology and Obstetrics (FIGO) stage I ovarian cancer.Methods Patients with a first diagnosis of ovarian cancer, diagnosed in the third quarter of 2004, 2008, 2012, and 2016, were documented. Surgical quality was categorized as optimal (maximum one surgical item missing) versus suboptimal (\>=2 surgical items missing). Chemotherapy was defined as optimal according to national guidelines. Treatment quality was classified into four categories: surgery and chemotherapy were optimal, optimal surgery and suboptimal chemotherapy, suboptimal surgery and optimal chemotherapy, and surgery and chemotherapy were suboptimal.Results In total, 19.9% (n=700) of ovarian cancer patients were diagnosed with FIGO stage I. Median age was 60 years (range 18\textendash96), 47.1% had FIGO stage IA and 47.9% had stage IC, with 37.1% high grade serous histology. Optimal surgical quality increased over time from 19.9% to 54.1%. The optimal surgery population increased from 42.2% to 70.9%. Disease free survival improved significantly in the optimal surgery population (84% after 48 months vs 71% in the suboptimal surgery population). Overall survival increased with 91% after 48 months in the optimal surgery population versus 76% in the suboptimal surgery population. In total, 20.7% of patients were undertreated concerning systemic treatment and 1% overtreated. Optimal chemotherapy standard was administered increasingly over time (71.4\textendash80.8%). Disease free survival and overall survival were prolonged with adjuvant chemotherapy. The optimal surgery/chemotherapy subgroup increased from 37.9% to 54.1% with significantly longer disease free survival and overall survival (overall survival at 48 months: optimal surgery and chemotherapy 93%; suboptimal surgery and chemotherapy 68%).Conclusion Although QS-OVAR data showed that the quality of therapy has improved over the years, not all surgical standards were met in nearly 50% of patients. The steady increase in the optimal surgery and chemotherapy collective is an important tool for improvement of prognosis of ovarian cancer patients.All data relevant to the study are included in the article or uploaded as supplementary information.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN532,

title = {Real World Daten zu Therapie und Krankheitsverlauf von Patientinnen mit erstem Rezidiv eines Ovarialkarzinoms in Deutschland (QS Ovar der AGO Studiengruppe)},

author = {B. Schmalfeldt and A. Bois and J. Pfisterer and F. Hilpert and M. Kerkmann and J. Sehouli and S. Mahner and N. Gregorio and L. Hanker and F. Heitz and F. Marm\'{e} and L. W\"{o}lber and L. Holtmann and A. Kr\"{u}ger and P. Harter},

url = {https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0042-1757039},

doi = {10.1055/s-0042-1757039},

issn = {0016-5751},

year  = {2022},

date = {2022-10-11},

urldate = {2022-10-11},

journal = {Geburtshilfe Frauenheilkd},

volume = {82},

number = {10},

pages = {319},

abstract = {Einleitung Deutschlandweite Daten zur Therapiequalit\"{a}t und zum Krankheitsverlauf von Patientinnen mit Rezidiv eines Ovarialkarzinoms gibt es bisher nicht.



Methodik Alle Krankenh\"{a}user in Deutschland, die Patientinnen mit Ovarialkarzinom behandeln, wurden angeschrieben, bei Patientinnen mit Erstdiagnose im dritten Quartal 2012 und 2016 Tumordaten, Therapie und Verlauf zu dokumentieren. In der vorliegenden Analyse wurden Therapie und Verlauf nach erstem Rezidiv ausgewertet.



Ergebnisse 840 Patientinnen mit Rezidiv wurden eingeschlossen. 754 (89,8%) wiesen eine high grade Histologie auf. Das mediane therapiefreie Intervall nach Abschluss der platinbasierten Erstlinientherapie betrug 12,4 Monate (Spannweite 0-55,7). Bei 144 (17,2%) wurde eine erneute zytoreduktive Chirurgie durchgef\"{u}hrt. Makroskopische Tumorfreiheit wurde bei 48,6% erreicht. Das PFS und OS dieser Patienten lag bei 18,3 und 31,5 Monaten. 599 Patientinnen erhielten eine Rezidivtherapie; bei 445 war diese platinbasiert. Das mediane PFS von Patientinnen mit platinfreier Therapie betrug 4,6 gegen\"{u}ber 11,5 Monaten bei platinbasierter Therapie (HR 0.37, 95%-CI 0.30-0.45, p\<0.001), das OS 9,4 versus 20,8 Monate (HR 0.46, 95%-CI 0.37-0.57, p\<0.001). Nur 4,7% der f\"{u}r eine platinhaltige Rezidivtherapie geeigneten Patientinnen waren unter dieser progredient. 120 Patienten f\"{u}hrten eine Erhaltungstherapie mit einem PARP Inhibitor durch. PFS und OS dieser Patientinnen lag bei 15,4 and 33,4 Monaten.



Schlussfolgerung Der Gro\ssteil der Patientinnen mit erstem Rezidiv erhielt eine erneute platinhaltige Therapie und nur sehr wenige davon waren sekund\"{a}r platinresistent. Das \"{U}berleben nach Rezidivoperation als auch mit PARP Inhibitor Erhaltungstherapie war besser als nach platinbasierter Therapie alleine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN531,

title = {Steigerung der Therapiequalit\"{a}t beim fr\"{u}hen Ovarialkarzinom: Ergebnisse der QS-Ovar},

author = {P. Wimberger and J. Pfisterer and A. Bois and F. Hilpert and M. Kerkmann and J. Sehouli and S. Mahner and N. Gregorio and L. Hanker and F. Heitz and F. Marm\'{e} and L. W\"{o}lber and L. Holtmann and G. Elser and P. Harter},

doi = {10.1055/s-0042-1757107},

issn = {0016-5751},

year  = {2022},

date = {2022-10-11},

urldate = {2022-10-11},

journal = {Geburtshilfe Frauenheilkd},

volume = {82},

number = {10},

pages = {387},

abstract = { Zielsetzung QS-Ovar dokumentierte von 2004 bis 2016 alle im 3. Quartal erstdiagnostizierten Ovarialkarzinome (OC). Diese repr\"{a}sentative Datenerhebung soll Umsetzung von Therapiestandards und Auswirkungen auf das \"{U}berleben f\"{u}r FIGO I Ovarialkarzinome evaluieren.



Methoden Die Therapiequalit\"{a}t orientierte sich an g\"{u}ltigen Therapiestandards und Leitlinien. OP-Qualit\"{a}t wurde als „optimal“ (OP+: maximal 1 OP-Parameter fehlend), vs. „suboptimal“ (OP-) kategorisiert.



Ergebnisse 19,9% (n=700) hatten ein FIGO I OC. Medianes Follow-up betrug 51,0 Monate. Medianes Alter war 60 Jahre. 40,1% waren ≥65 Jahre, 47,1% mit FIGO IA, 47,9% FIGO IC. 37,1% waren high-grade ser\"{o}s. Die OP-Qualit\"{a}t nahm im Verlauf zu. Der operative Standard erh\"{o}hte sich im Beobachtungszeitraum von 19,9% auf 54,1%. Das OP+ Kollektiv stieg von 42,2% auf 70,9%. Das progressionfreie Survival (PFS) war signifikant verbessert bei OP+ (84% nach 48 Monaten im Vergleich zu 71% bei nicht optimaler Operation). Ebenso war das Gesamt\"{u}berleben (OS) signifikant verl\"{a}ngert mit 91% nach 48 Monaten bei OP+ vs. 76% bei OP-. 20,7% wurden systemtherapeutisch untertherapiert, 1,0% \"{u}bertherapiert. Der optimale Chemotherapiestandard (CT+) wurde zunehmend h\"{a}ufiger verabreicht (71,4% auf 80,8%). PFS und OS waren signifikant verl\"{a}ngert bei CT+. Die OP+/CT+ Subgruppe stieg im Verlauf von 37,9% auf 54,1% und war mit signifikant verl\"{a}ngertem PFS und OS assoziiert (OS (48 Monate): OP+/CT+ 93%, OP-/CT+ 68%).



Zusammenfassung Zwar geht aus den retrospektiven QS-Ovar-Daten hervor, dass sich die Therapiequalit\"{a}t im Laufe der Jahre stetig verbessert hat, allerdings wurden bei fast 50% immer noch nicht alle operativen Standards eingehalten. Die kontinuierliche Erh\"{o}hung des OP+/CT+ Kollektivs ist somit ein wichtiges Instrument zur Verbesserung der Prognose von Ovarialkarzinompatientinnen.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{nokey,

title = {Qualit\"{a}tssicherung zum An\"{a}miemanagement bei Patientinnen und Patienten mit soliden Tumoren und h\"{a}matologischen Neoplasien (V808)},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann},

url = {https://www.karger.com/Article/Pdf/526456},

doi = {10.1159/000526456},

year  = {2022},

date = {2022-10-10},

urldate = {2022-10-10},

journal = {Oncology Research and Treatment},

volume = {45},

issue = {suppl 2},

pages = {251},

abstract = {Introduction: 

Anemia is a frequent complication in patients with breast cancer (BC), gastrointestinal tumors (GC), lung cancer (LC) and malignant lymphomas (ML). Guidelines (GL) on anemia management (ESMO; DGHO) provide dedicated algorithms for diagnosis and treatment of anemia. Aim of the study was to analyze GL adherence (GLAD) in Germany. 

Methods: 

This was a retrospective sample analysis representative for practices and hospitals in Germany. Data on tumor treatments and anemia management was collected from records of cancer patients (pts) with grade ≥ 2 anemia diagnosed between January and June 2021. Definition of diagnosis GLAD score (GLAD-D): 2 points (pt) for full adherence, 1 pt for a lack in differential diagnosis on iron metabolism. 0 pt if differential diag- nosis is missing. Treatment GLAD score (GLAD-T): 2 pt for full adherence to GL recommendation in relation to diagnosis. 1 pt for indicated red blood cells (RBC) as only anemia therapy or no therapy in pts with Hb ≥8g/dl. 0 pt for RBC without indication, p.o. iron substitution under inflammatory conditions (CRP\>5mg/l) or vitamin B12 or folate deficiency without substitution. Results: Data from 1046 pts (311 BC, 371 GC, 260 LC, 104 ML) were collected from 143 centers. 996 (92.4%) pts were treated with medical tumor therapy and 317 (30.3%) received radiotherapy. Hb-values at diagnosis of anemia were 8-10 g/dl in 899 (85.9%) pts, 6-8g/dl in 135 (12.9%) and \<6g/dl (1.2%) in 12 pts. 456 pts were treated with RBC (43.6%), 198 (18.9%) with iron substitution, 106 (10.1%) with ESA and 60 (5.7%) with vitamin B12. 60.6% of the pts with iron substitution were treated i.v. and 39.4% p.o. 37.5% of pts with RBC had no indication in the sense of the restrictive RBC policy recommended by the GLs.

GLAD was poor in diagnosis and treatment: GLAD-D was 2 pt in 310 pts (29.6%) of pts, 1 pt at 168 (16.1%) and 0 pt in 568 (54.3%) pts. GLAD-T was 2 pt in 270 pts (25.8%), 1 pt in 310 (29.6%) and 0 pt in 466 (44.6%).

Higher GLAD-D correlated significantly to a higher GLAD-T (τB 0.262, p\<0.001). Full GLAD-T (2 pt) was significantly associated with a greater Hb increase than GLAD-T 0/1 (p\<0.001) at 28 days (10.2 vs. 9.7 g/dl) and at 2 months (10.4 vs 9.9 g/dl).

Conclusions

Pts with anemia management as per GL had a significantly stronger Hb-increase. GLAD is poor in Germany, especially concerning the too liberal transfusion policy and the lack of differential diagnostics of iron metabolism.

NCT05190263},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN526,

title = {Qualit\"{a}tssicherung zur Therapie des muskelinvasiven und metastasierten Harnblasenkarzinoms in Deutschland},

author = {Carsten-Henning Ohlmann and Markus Kerkmann and Laura Holtmann and J\"{u}rgen E. Gschwend and Margitta Retz and Maike de Wit},

url = {https://doi.org/10.1007/s00120-022-01870-z},

doi = {10.1007/s00120-022-01870-z},

issn = {2731-7072},

year  = {2022},

date = {2022-06-29},

urldate = {2022-06-29},

journal = {Die Urologie},

volume = {61},

pages = {1351-1364},

abstract = {Background:

The S3-guideline on bladder cancer recommends radical cystectomy and cisplatin-based perioperative chemotherapy (POC) for muscle-invasive bladder cancer (MIBC). Recommendation for metastatic urothelial cancer (mUC) is cisplatin-based or immuno-oncological (IO) treatment in platinum-ineligible patients (pts) or as 2nd-line therapy.

Objectives:

Aim of the study was to obtain representative data on clinical routine treatment of MIBC and mUC in Germany.

Materials and methods:

A nationwide survey was performed to obtain data on stage-related patient volume in hospitals and office-based physicians. Based on these results, a representative sample of treatment data was collected retrospectively from pts with MIBC and mUC.

Results:

Data from 956 pts (MIBC 576; mUC: 380) were collected. Of the MIBC pts, 49.8% received a systemic therapy (80.4% of them received cisplatin/gemcitabine) and 50.2% were treated with a cystectomy without POC. Significant factors for cystectomy without POC were higher age \> 75 years (odds ratio [OR] 4.91, 95% confidence interval [CI] 3.01\textendash8.11, p \< 0.001) and platinum-ineligible pts (OR 2.15, 95% CI 1.30\textendash3.59; p = 0.003). Treatment decision without interdisciplinary tumor board was also correlated with no POC (OR 2.43, 95% CI 1.65\textendash3.61, p \< 0.001). In mUC platinum-pretreated pts generally receive IO therapy (OR 12.07, 95% CI 6.94\textendash21.82, p \< 0.001). Other significant factors are positive PD-L1 status (OR 3.72, 95% CI 1.30\textendash5.71, p \< 0.001), higher age \> 75 years (OR 2.83, 95% CI 1.43\textendash5.73, p = 0.003) and platinum-ineligible pts (OR 2.57, 95% CI 1.30\textendash5.71, p = 0.007).

Conclusions:

The “gold standard” cisplatin/gemcitabine is established in Germany if pts are treated with POC. Nonetheless half of the MIBC pts did not receive a POC, especially if the treatment decision is not discussed in a tumor board. In mUC IO therapy is established as 2nd-line therapy after a platinum-based treatment. Although the guideline recommendations are largely implemented, there is potential for optimization, especially in the establishment of interdisciplinary tumor boards.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN524,

title = {Immunoglobulin substitution in patients with secondary antibody deficiency in chronic lymphocytic leukemia and multiple myeloma: a representative analysis of guideline adherence and infections},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann and Working Groups Supportive Care (AGSMO), Medical Oncology (AIO) of the German Cancer Society (DKG)},

url = {https://doi.org/10.1007/s00520-022-06920-y},

doi = {10.1007/s00520-022-06920-y},

issn = {1433-7339},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Supportive Care in Cancer},

volume = {30},

number = {6},

pages = {5187-5200},

abstract = {Introduction

In secondary immunodeficiency, immunoglobulin replacement therapy (IgRT) is recommended by guidelines (GL) for patients with IgG level \< 4 g/l and more than 3 infections or a severe infection. IgRT may be appropriate if IgG level \< 4 g/l and/or 1\textendash3 less severe infections (≤ grade 2).

Methods

This was a retrospective sample analysis representative for practices and hospitals in Germany. The treatments and infection data were collected from patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). GL adherence (GLAD) was analyzed.

Results

Data from 1086 patients (CLL 490, MM 596) were collected from 86 centers. Of all patients, 34.8% developed IgG deficiency during therapy (CLL 35.5%; MM 34.2%). IgRT was given in 23.5% of CLL and 14.4% of MM patients. GLAD in hypogammaglobulinemia and indication to IgRT was 23.3% of 86 CLL and 22.1% of 77 MM patients. Without GLAD, the hazard ratio (HR) for any infection was 4.49 (95% CI 3.72\textendash5.42; p \< 0.001) and for severe infections (grade ≥ 3) 10.64 (95% CI 7.54\textendash15.00; p \< 0.001). Significant independent risk factors for infections were a higher Charlson Comorbidity Index, IgG deficiency, and 3rd + line treatment, as well as therapy with BTK inhibitors or chemotherapy in CLL. Multivariable analysis showed a significantly lower risk of severe infections after start of IgRT with a HR of 0.47 (95% CI 0.28\textendash0.77; p = 0.003).

Conclusions

Guideline adherence correlated with fewer and less severe infections but was low in patients with indication to IgRT. Risk factors for infection can be identified. Risk of severe infections was significantly lower in patients with IgRT.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN527,

title = {Treatment and outcome of patients with high-grade advanced ovarian cancer (AOC): Real-world data in Germany (QS Ovar of the AGO Study Group)},

author = {Sven Mahner and Philipp Harter and Andreas Du Bois and Felix Hilpert and Markus Kerkmann and Jalid Sehouli and Nikolaus Gregorio and Lars Ch Hanker and Florian Heitz and Frederik Marm\'{e} and Linn Lena Woelber and Laura Holtmann and Gabriele Elser and Jacobus Pfisterer},

url = {https://doi.org/10.1200/JCO.2022.40.16_suppl.e17613},

doi = {10.1200/JCO.2022.40.16_suppl.e17613},

issn = {0732-183X},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Journal of Clinical Oncology},

volume = {40},

number = {16_suppl},

pages = {e17613-e17613},

abstract = {Background: 

Outcome of patients with ovarian cancer depends largely on treatment quality and expertise of treating physicians and centers. To assess treatment reality and quality in Germany, we initiated a nationwide quality assurance program. 

Methods: 

All German hospitals treating patients with ovarian cancer were asked to document their patients with primary diagnosis of epithelial ovarian cancer in the third quarters of 2012 and 2016. Details of tumor, treatment and outcome were documented in a central database. The current analysis focuses on patients with high-grade AOC stage III/IV. 

Results: 

In total, 1010 patients with high-grade AOC were documented. This represents 63% of all patients diagnosed with AOC in Germany in these periods. Median age was 65 years. The majority (774/1010 - 76.6%) were diagnosed with stage III disease and 947/1010 (93.8%) had serous, 34 (3.4%) endometrioid and 29 (2.9%) clear cell histology. 915/1010 (90.6%) had primary cytoreductive surgery. Complete resection was achieved in 434/915 (47.4%) at primary surgery and in 54/95 (56.8%) at interval debulking surgery. Median PFS and OS in patients with primary surgery and complete resection was 29.7 months and 63.1 months compared to 16.8 months and 30.7 months in patients with residual disease (HR PFS 0.46 95% CI 0.22-0.54 HR OS: 0.38 95% CI 0.31-0.45). In patients with neoadjuvant chemotherapy and interval debulking, median PFS and OS were 24.3 and 50.7 months with complete resection, compared to 15.4 and 33.9 months with residual disease (HR PFS 0.61 95% CI 0.38-0.95 HR OS: 0.48 95% CI 0.28-0.83). First-line chemotherapy was carboplatin/paclitaxel (TC) in 919/1010 (91%) of the patients, 627 (62%) also received bevacizumab (TCB) and 544 of these (87%) also received maintenance therapy. Median PFS and OS in patients with TCB was 23.3 months and 46.2 months and 18.5 months and 39.0 months in patients treated with TC (p = 0.049: HR 0.85, 95% CI 0.72-1.00 and p = 0.012: HR 0.79, 95% CI 0.65-0.95). The rate of complete tumor resection at surgery as well as the use of bevacizumab increased between the two periods. 

Conclusions: 

Based on this representative cohort of patients with advanced ovarian cancer in Germany, the majority of patients is treated with primary surgery followed by carboplatin/paclitaxel and bevacizumab. Patient outcome regarding PFS and OS was best when complete tumor resection was achieved at primary surgery and patients received combination chemotherapy with maintenance treatment. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN478,

title = {An\"{a}mie \textendash Diagnostik und Therapie bei soliden Tumoren und malignen Lymphomen},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann},

url = {https://doi.org/10.1007/s12312-021-00948-7},

doi = {10.1007/s12312-021-00948-7},

issn = {2190-9784},

year  = {2021},

date = {2021-01-01},

urldate = {2021-01-01},

journal = {Forum},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{HarterA200,

title = {123 Real world data of treatment and outcome of patients with high grade AOC (advanced ovarian cancer) in Germany (QS Ovar)},

author = {Philipp Harter and Andreas Du Bois and Felix Hilpert and Markus Kerkmann and Jalid Sehouli and Sven Mahner and Nikolaus De Gregorio and Lars Hanker and Florian Heitz and Frederik Marm\'{e} and Linn W\"{o}lber and Laura Holtmann and Jacobus Pfisterer},

url = {https://ijgc.bmj.com/content/31/Suppl_3/A200.1},

doi = {10.1136/ijgc-2021-ESGO.342},

issn = {1048-891X},

year  = {2021},

date = {2021-01-01},

urldate = {2021-01-01},

journal = {International Journal of Gynecologic Cancer},

volume = {31},

number = {Suppl 3},

pages = {A200--A200},

publisher = {BMJ Specialist Journals},

abstract = {Introduction/Background*Recent and detailed data regarding treatment quality and outcome of patients with high grade AOC on a nationwide basis are largely unknown in Germany.Methodology All German hospitals treating patients with ovarian cancer were asked to document all patients with first diagnosis in the third quarter in 2012 and 2016. Details of tumor, treatment and outcome were documented. This analysis is focusing on patients with AOC FIGO III/IV and the endpoint PFS (progression free survival) (OS data immature for 2016 cohort). As response rates were not documented, we defined a subcohort of patients without progressive disease within 3 months after end of chemotherapy as potential candidates for an additional maintenance therapy.Result(s)*In total, 1010 patients with high grade AOC with a median age of 65 years were documented. 774/1010 (76.6%) were diagnosed with FIGO III disease and 947/1010 (93.8%) had high-grade serous histologic subtype. 915/1010 (90.6%) had primary cytoreductive surgery. Complete resection was achieved in 434/1010 (43.0%) at primary surgery and in 54/1010 (5.3%) at interval debulking surgery. Carboplatin/paclitaxel/bevacizumab (TCB) was the primary systemic therapy in 627/1010 (62.1%) and carboplatin/paclitaxel (TC) in 292/1010 (28.9%). Median PFS in patients with primary surgery and complete resection was 29.7 months (95% CI 27.4-34.2) compared to 17.2 months (95% CI 15.7-18.9) in all other patients (p\<0.001: HR 0.49, 95% CI 0.42-0.57). Median PFS in patients with TCB was 23.3 months (95% CI 22.0-25.3) and 18.5 months (95% CI 15.7-21.9) in patients treated with TC (p=0,083: HR 0.87, 95% CI 0.74-1.02). In total, 899/1010 (89%) did not progress within 3 months.Conclusion*Most patients in Germany with high grade AOC are treated with primary surgery followed by carboplatin/paclitaxel/bevacizumab. Depending on biomarker status most patients are potential candidates for a PARP-inhibitor maintenance therapy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN66,

title = {Die Therapiequalit\"{a}t des fortgeschrittenen Ovarialkarzinoms in Deutschland},

author = {P. Harter and J. Pfisterer and F. Hilpert and J. Sehouli and C. Lamparter and M. Kerkmann and A. Bois},

url = {https://www.eierstock-krebs.de/wp-content/uploads/2020/04/FA-2020-03-DIAG_Harter.pdf},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Frauenarzt},

volume = {61},

number = {3},

pages = {182-188},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN480,

title = {Steigerung der Therapiequalit\"{a}t des Ovarialkarzinoms in Deutschland \textendash Ergebnisse der eigenverantwortlichen QS Ovar},

author = {F. Hilpert and A. Bois and J. Pfisterer and J. Sehouli and C. Lamparter and M. Kerkmann and P. Harter},

url = {http://dx.doi.org/10.1055/s-0040-1718217},

doi = {10.1055/s-0040-1718217},

issn = {0016-5751 DOI - 10.1055/s-0040-1718217},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Geburtshilfe Frauenheilkd},

volume = {80},

number = {10},

pages = {P389},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN466,

title = {Guideline adherence in bone-targeted treatment of cancer patients with bone metastases in Germany},

author = {Hartmut Link and Ingo Diel and Carsten- H. Ohlmann and Laura Holtmann and Markus Kerkmann and Medical Oncology Urological Oncology German Cancer Society Oncology and Society German Osteooncological},

url = {https://doi.org/10.1007/s00520-019-05018-2},

doi = {10.1007/s00520-019-05018-2},

issn = {1433-7339},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Supportive Care in Cancer},

volume = {28},

number = {5},

pages = {2175-2184},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN467,

title = {Quality assurance on diagnosis and therapy of secondary immunodeficiencies (SID) in patients with chronic lymphocytic leukemia (CLL) or multiple myeloma (MM) in Germany (QS-SID)},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann},

doi = {10.1159/000510995},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Oncology Research and Treatment},

volume = {43},

number = {Suppl. 4},

pages = {A280},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN537,

title = {QS ENDO Real - A Study by the German Endometriosis Research Foundation (SEF) on the Reality of Care for Patients with Endometriosis in Germany, Austria and Switzerland},

author = {F. Zeppernick and M. Zeppernick and E. Janschek and M. W\"{o}lfler and S. Bornemann and L. Holtmann and F. Oehmke and I. Brandes and C. M. Scheible and D. Salehin and S. V. Pethick and A. S. Boosz and B. Kr\"{a}mer and M. Sillem and K. B\"{u}hler and J. Keckstein and K. W. Schweppe and I. Meinhold-Heerlein},

doi = {10.1055/a-1068-9260},

issn = {0016-5751 (Print) 0016-5751},

year  = {2020},

date = {2020-01-01},

urldate = {2020-01-01},

journal = {Geburtshilfe Frauenheilkd},

volume = {80},

number = {2},

pages = {179-189},

abstract = {Endometriosis affects a significant number of young premenopausal women. Quite apart from the medical challenges, endometriosis is a relevant burden for healthcare and social security systems. Standardized quality indicators for the treatment of endometriosis have not previously been systematically verified. The three-stage study QS ENDO was initiated to record and improve the reality and quality of care. One of its aims is to create quality indicators for the diagnosis and treatment of endometriosis. For the first stage of QS ENDO Real, letters were sent to all 1014 gynecological departments in the German-speaking area of Europe (the DACH region) which included a questionnaire as a means of surveying the current state of care. A total of 296 (29.2%) of the centers which received the questionnaire participated in the survey. The subsequent evaluation of the completed questionnaires showed that the majority of patients with endometriosis (around 60%, based on estimates from the data) are not treated in hospitals which have been certified by the SEF. The guidelines recommend the use of specific classification systems (rASRM, ENZIAN) but, depending on the level of care offered by the hospital, only around 44.4 to 66.4% of departments used the rASRM score and only 27% of hospitals used the ENZIAN classification system to describe deep-infiltrating endometriosis. When taking patientsʼ medical history, some centers (6.6 \textendash 17.9%) considered questions about leading symptoms such as dyschezia, dysuria and dyspareunia to be unimportant. QS ENDO Real has made it possible, for the first time, to get an overview of the reality of care provided to patients with endometriosis in the German-speaking areas of Europe. The findings indicate that several of the measures recommended in international guidelines as the gold standard of care are only used to treat some of the patients. In this respect, more efforts will be needed to provide more advanced training. The approach used for treatment must be guideline-based, also in not-certified centers, to improve the quality of care in the treatment of patients with endometriosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN20,

title = {EP869 Treatment of ovarian cancer in Germany from 2004\textendash2016: results of a nationwide quality assurance program (QS Ovar)},

author = {P Harter and J Pfisterer and F Hilpert and J Sehouli and C Lamparter and M Kerkmann and A Bois},

url = {https://ijgc.bmj.com/content/ijgc/29/Suppl_4/A471.2.full.pdf},

doi = {10.1136/ijgc-2019-ESGO.917},

year  = {2019},

date = {2019-01-01},

journal = {International Journal of Gynecologic Cancer},

volume = {29},

number = {Suppl 4},

pages = {A471-A471},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN1,

title = {Guideline adherence in bone-targeted treatment of cancer patients with bone metastases in Germany},

author = {H Link and I Diel and C H Ohlmann and L Holtmann and Urological Oncology (AUO) Medical Oncology (AIO) M Kerkmann for the Associations Supportive Care in Oncology (AGSMO) and German Osteooncological Society (DOG)},

url = {https://www.ncbi.nlm.nih.gov/pubmed/31410600},

doi = {10.1007/s00520-019-05018-2},

issn = {1433-7339 (Electronic) 0941-4355 (Linking)},

year  = {2019},

date = {2019-01-01},

journal = {Support Care Cancer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN19,

title = {Sekund\"{a}re Immundefekte im Zeitalter zielgerichteter Therapien},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann},

url = {https://doi.org/10.1007/s12312-019-00707-9},

doi = {10.1007/s12312-019-00707-9},

issn = {2190-9784},

year  = {2019},

date = {2019-01-01},

urldate = {2019-01-01},

journal = {Forum},

volume = {34},

number = {6},

pages = {561-562},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN21,

title = {Behandlungsqualit\"{a}t des Ovarialkarzinoms in Deutschland: Aktuelle Ergebnisse des Qualit\"{a}tssicherungsprogramms QS OVAR},

author = {S Mahner and A Bois and J Pfisterer and F Hilpert and J Sehouli and C Lamparter and M Kerkmann and P Harter},

doi = {10.1055/s-0039-1693901},

issn = {0016-5751},

year  = {2019},

date = {2019-01-01},

journal = {Geburtshilfe Frauenheilkd},

volume = {79},

number = {08},

pages = {PD45},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN486,

title = {G-CSF guideline adherence in Germany, an update with a retrospective and representative sample survey},

author = {Hartmut Link and Markus Kerkmann and Laura Holtmann and Petra Ortner and Care Working Groups Supportive and Society Medical Oncology German Cancer},

url = {https://doi.org/10.1007/s00520-018-4481-x},

doi = {10.1007/s00520-018-4481-x},

issn = {1433-7339},

year  = {2019},

date = {2019-01-01},

urldate = {2019-01-01},

journal = {Supportive Care in Cancer},

volume = {27},

number = {4},

pages = {1459-1469},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN528,

title = {Therapieadh\"{a}renz beim Mammakarzinom im fr\"{u}hen (EBC) und metastasierten Setting (MBC) in Deutschland. Analyse der Organkommission Mamma der AGO 2004 \textendash 2018},

author = {C. Jackisch and T. Decker and J. Schilling and S. Schmitz and W. Lichtenegger and A. Jaeger and S. Bornemann},

url = {https://doi.org/10.1055/s-0039-1687991},

doi = {10.1055/s-0039-1687991},

issn = {1611-6453 DOI - 10.1055/s-0039-1687991},

year  = {2019},

date = {2019-01-01},

urldate = {2019-01-01},

journal = {Senologie - Zeitschrift f\"{u}r Mammadiagnostik und -therapie},

volume = {16},

number = {02},

pages = {58},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN22,

title = {Therapy of ovarian cancer (OC) in Germany \textendash Treatment characteristics and survival results of the QS OVAR 2012},

author = {P Harter and A Bois and F Hilpert and J Rochon and C Lamparter and M Kerkmann and J Pfisterer},

doi = {10.1055/s-0038-1671031},

issn = {0016-5751},

year  = {2018},

date = {2018-01-01},

journal = {Geburtshilfe Frauenheilkd},

volume = {78},

number = {10},

pages = {P 120},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN23,

title = {Combination of conventional prognostic factors and molecular subtypes for selecting the timing of systemic therapy in early operable breast cancer.},

author = {Christian Jackisch and Andreas Jaeger and Sebastian Bornemann},

url = {https://www.karger.com/DOI/10.1159/000487109},

doi = {10.1159/000487109},

issn = {2296-5270},

year  = {2018},

date = {2018-01-01},

urldate = {2018-01-01},

journal = {Oncology Research and Treatment},

volume = {41(suppl 1)},

number = {ID 510},

pages = {1-221},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN27,

title = {QS Endo \textendash Eine Studie zur Versorgungsqualit\"{a}t von Endometriosepatientinnen in Deutschland, \"{O}sterreich und der Schweiz},

author = {M Zeppernick and F Zeppernick and I Meinhold-Heerlein},

doi = {10.1055/s-0038-1671384},

issn = {0016-5751},

year  = {2018},

date = {2018-01-01},

journal = {Geburtshilfe Frauenheilkd},

volume = {78},

number = {10},

pages = {P 220},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN414,

title = {Qualit\"{a}tssicherung Ovarialkarzinom in Deutschland - Erhebung 2016},

author = {P Harter and F Hilpert and J Pfisterer and J Sehouli and C Lamparter and M Kerkmann and A Du Bois},

doi = {10.1055/s-008-41512},

year  = {2018},

date = {2018-01-01},

urldate = {2018-01-01},

journal = {Geburtshilfe und Frauenheilkunde},

volume = {78},

number = {10},

pages = {94},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN415,

title = {Guideline adherence in bone targeted therapy of cancer patients with bone metastases in Germany},

author = {Hartmut Link and Ingo Diel and Carsten-Henning Ohlmann and Laura Holtmann and Markus Kerkmann},

url = {https://www.karger.com/Article/Pdf/479566#634},

issn = {2296-5270},

year  = {2017},

date = {2017-01-01},

urldate = {2017-01-01},

journal = {Oncology Research and Treatment},

volume = {40},

number = {Suppl 3},

pages = {P634},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN24,

title = {Timing der (neo)adjuvanten Systemtherapie beim Mammakarzinom in Deutschland in den Jahren 2004 bis 2014. Resultate der Erhebungen der Organkommission Mamma der AGO mit Unterst\"{u}tzung von AIO, BNGO, BNHO, NOGGO.},

author = {C Jackisch and U -S Albert and I Bauerfeind and J -U Blohmer and P Dall and V Heinemann and H -J Hindenburg and A Jaeger and C Lamparter and W Lichtenegger and H -J L\"{u}ck and G Minckwitz and V M\"{o}bus and U Nitz and S Schmitz and M Untch and A Scharl},

url = {https://www.karger.com/DOI/10.1159/000444354},

doi = {10.1159/000444354},

issn = {2296-5270},

year  = {2016},

date = {2016-01-01},

journal = {Oncology Research and Treatment},

volume = {39(suppl 1)},

number = {ID 0357},

pages = {1-191},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{RN3g,

title = {Adherence to granulocyte-colony stimulating factor (G-CSF) guidelines to reduce the incidence of febrile neutropenia after chemotherapy--a representative sample survey in Germany},

author = {Hartmut Link and Josef Nietsch and Markus Kerkmann and Petra Ortner German Cancer Society (DKG)},

url = {https://www.ncbi.nlm.nih.gov/pubmed/26081593},

doi = {10.1007/s00520-015-2779-5},

issn = {1433-7339 (Electronic) 0941-4355 (Linking)},

year  = {2016},

date = {2016-01-01},

urldate = {2016-01-01},

journal = {Support Care Cancer},

volume = {24},

number = {1},

pages = {367-376},

keywords = {},

pubstate = {published},

tppubtype = {article}

}