Background/Objectives: The certification of hospitals as colorectal cancer centers aims to improve treatment quality, but evidence supporting its effectiveness remains limited. This study evaluated the impact of certification on treatment outcomes for rectal cancer patients in Germany.Methods: We conducted a retrospective analysis of 14,905 patients with primary rectal cancer (UICC Stages I-III) treated at 271 hospitals. Treatment outcomes were compared between certified colorectal cancer centers (3624 patients in 55 hospitals) and non-certified hospitals (11,281 patients in 216 hospitals). Additionally, a subset analysis examined outcomes before and after certification within the same institutions.Results: Certified centers demonstrated higher utilization of preoperative imaging (endorectal ultrasound: 70.7% vs. 58.2%,p< 0.001; pelvic MRI: 39.1% vs. 28.5%,p< 0.001) and lower rates of intraoperative complications (4.6% vs. 6.2%,p< 0.001). Surgical quality indicators, including M.E.R.C.U.R.Y. classification (Grade 1: 86.5% both groups,p= 0.620) and anastomotic leakage rates (11.3% vs. 11.9%,p= 0.407), were comparable between certified and non-certified hospitals. Despite treating patients with more favorable tumor stages, certified centers showed no significant advantage in 5-year overall survival (82.8% vs. 82.0%,p= 0.880) or 30-day mortality (2.6% both groups,p= 0.869). Hospital stays were marginally shorter in certified centers (19.46 vs. 20.24 days,p< 0.001).Conclusions: While certification was associated with improved adherence to diagnostic protocols and reduced intraoperative complications, it did not significantly impact surgical quality or long-term survival outcomes. These findings suggest that certification alone may not guarantee superior treatment quality, as hospitals participating in quality assurance programs achieved comparable results without formal certification.
**背景/目的：** 结直肠癌中心认证旨在提高治疗质量，但支持其有效性的证据仍然有限。本研究评估了在德国，认证对直肠癌患者治疗结局的影响。 **方法：** 我们对271家医院收治的14,905例原发性直肠癌（UICC I-III期）患者进行了回顾性分析。比较了经认证的结直肠癌中心（55家医院，3624例患者）与未经认证医院（216家医院，11,281例患者）的治疗结局。此外，还对同一机构在认证前后的结局进行了亚组分析。 **结果：** 认证中心显示出更高的术前影像学检查使用率（直肠内超声：70.7% vs. 58.2%，p < 0.001；盆腔MRI：39.1% vs. 28.5%，p < 0.001）和更低的术中并发症发生率（4.6% vs. 6.2%，p < 0.001）。手术质量指标，包括M.E.R.C.U.R.Y.分级（1级：两组均为86.5%，p = 0.620）和吻合口漏发生率（11.3% vs. 11.9%，p = 0.407），在认证与非认证医院之间具有可比性。尽管认证中心治疗的患者肿瘤分期更有利，但在5年总生存率（82.8% vs. 82.0%，p = 0.880）或30天死亡率（两组均为2.6%，p = 0.869）方面并未显示出显著优势。认证中心的住院时间略短（19.46天 vs. 20.24天，p < 0.001）。 **结论：** 虽然认证与提高诊断方案依从性和减少术中并发症相关，但并未显著影响手术质量或长期生存结局。这些发现表明，仅凭认证可能无法保证更优的治疗质量，因为参与质量保证计划但未经正式认证的医院也取得了可比的结果。
肿瘤(癌症)患者之家