DRG-based analysis of inpatient treatment of head and neck cancer in Germany

Introduction Changes in inpatient treatment of head and neck tumors (HNC) in Germany were not yet analyzed in detail.

Methods The nationwide Diagnosis-Related-Groups (DRG) statistics from 2005 to 2018 were used. All cases with HNC (except thyroid cancer) were included (n=1,226,856 procedures with 217,859 biopsies, 378,151 surgeries of primary HNC, 152,207 neck dissections, 237,728 radiotherapies and 240,911 chemo-/immunotherapies). The treatment rates per 100,000 German citizens were calculated and the influence over the time of gender and localization were examined with regression analysis.

Results Surgery of the primary tumor led treatment rates (5.50±3.84 per 100,000 per year), followed by radiotherapy (3.46±1.56), chemo-/immunotherapy (3.51±1.51), biopsies (3.17±1.73) and neck dissection (2,21±1.59). Women with oropharyngeal cancer showed a significant increase in radiotherapy rates (relative risk [RR] 1.18, 95% confidence interval [CI] 1.10-1.27, p<.0001) over the years, men with hypopharyngeal cancer showed a decrease (RR 0.93, CI 0.87-0.98, p=0.0093). The same was observed with chemo-/immunotherapy, with the largest increase for women with oropharyngeal cancer (RR 1.16, CI 1.08-1.24, p<.0001) and the largest decrease for men with hypopharyngeal cancer (RR 0.93, CI 0.88-0.97, p=0.0014). Surgery rates showed the highest increase for women with cancer of the oral cavity (RR 1.14, CI 1.11-1.18, p<.0001), the largest decrease was seen for men with laryngeal cancer (RR 0.90, CI 0.87-0.93, p<.0001).

Discussion Treatment rates changed for almost all localizations and forms of therapy. The results revealed relevant gender-specific differences.

Publication History

Article published online:
24 May 2022