Quality of care in oncology: quality indicators in testicular cancer: a hospital-based approach

Introduction: The Belgian Health Care Knowledge Centre (KCE) conducted a literature search leading to twelve quality indicators for testicular cancer. Data obtained from three nationwide databases, showed only five fully measurable quality indicators, one was partially measurable, and two could be determined using a proxy indicator. The four remaining indicators could not be assessed. In this study, we aimed to investigate if these quality indicators were registered and measurable in a medium-volume center. Methods: In our medium-volume cancer center new testicular cancer diagnoses were registered since 2003. 48 patients were diagnosed with testicular cancer between 2004 and 2014. Through medical file review we measured and evaluated the predefined set of indicators. The results were pooled in a database and compared to the KCE report (KCE Reports 149A. D2010/10.273/96). Results: All 12 indicators could be measured in the entire patient cohort of 48 patients. Mean age was 34.9 years (range 16-85). In comparison with the KCE report, we documented higher rates of tumor marker assessment (98% vs. 73%), staging imaging (100% vs. 95%), multidisciplinary board discussion (100% vs. 58%), orchidectomy (98% vs. 84%), follow-up imaging (100% vs. 54%), and active surveillance (77% vs. 21%). In contrast, we found a lower rate of radiotherapy (6% vs. 20.3%) and chemotherapy (41.6% vs. 53%). Two patients were lost to follow-up, the remaining 46 patients are still alive. Four patients relapsed, all were seminomas. Conclusion: Implementation of quality indicators for testicular cancer is feasible for a medium-volume peripheral cancer center.