Application of adjuvant chemotherapy in colorectal cancer -- a survey in the region of Essen, Germany.
BACKGROUND
The value of adjuvant chemotherapy (AC) in colorectal carcinoma (CRC) is definitely proven and its application is clearly recommended by the German Cancer Society (GCS). The goal of this study was to investigate whether these findings and recommendations have been introduced in daily practice and whether this might depend on the specialization of the treating physicians.


METHODS
Patients presenting with CRC in the department of oncology of the Kliniken Essen-Mitte between 1997 and 2002 who had started AC until the end of 2001 were evaluated. Data on AC were collected retrospectively from patients' records and prospectively by patient interviews. We investigated whether the guidelines of the GCS were followed and whether 5-fluorouracil (5-FU) was applied properly and we correlated the results with the treating institution.


RESULTS
133 patients were analyzed for correlation of their treatment with the guidelines of the GCS. In 81% the AC met these guidelines. This was significantly more frequent in oncologic institutions than in non-specialized ones (96 vs. 9%, p < 0.001). Regarding dose and infusion time chemotherapy was properly administered to 83% of the patients (109/132) treated with 5-FU. Again, correct treatment was significantly correlated with specialization of the physicians (98 vs. 9%, medical oncology vs. other, p < 0.001).


CONCLUSIONS
The results of our random search in the region of Essen, Germany, lead to the hypothesis that a quality-assured chemotherapy is best provided by specialized oncologic institutions, even if the treatment has been established for years. This should be proven by a large epidemiologic study.
Stahl
Michael
M
Klinik für Innere Medizin IV (Internistische Onkologie und Hämatologie mit Zentrum für Palliativmedizin), Kliniken Essen-Mitte, Essen, Germany. m.stahl@kliniken-essen-mitte.de
Schweers
Krista
K
Müller
Christian
C
Köster
Wolf
W
Wilke
Hansjochen
H
D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys / Q000379:methods; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000379:methods*; D017211:Treatment Failure; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D005472:Fluorouracil