LAUSR

Abstract Background The Thoracic Oncology Centre of the University Hospital Zurich, founded in 2011, is certified by the German Cancer Society, and is one of 17 multidisciplinary organ-based centres of the CCCZ. All treatment recommendations are made at a multidisciplinary tumor board. Since 1980, all new cancer cases among the population of both cantons Zurich and Zug, are registered in the KKR. Methods The aim of the current study is to quantify the mortality risk of patients with NSCLC and identify differences on survival time and other factors between patients receiving their primary treatment at the CCCZ and those treated elsewhere and registered by KKR. Association of sex, histology, stage and age at initial diagnosis to survival as well as differential effect on survival between CCCZ and KKR are also explored. Imputation of last follow-up date of KKR by the database cut-off date (7 August 2018) was used, to address possible underestimation of survival due to missingness in this centre. Results Patients included 848 primary cases from the CCCZ and 1761 cases from the KKR diagnosed between January 1, 2011 and December 31, 2015. A comparable median follow-up time of 57 months and 56 months for CCCZ and KKR patients, respectively, was calculated. OS is significantly superior for CCCZ patients as compared to KKR patients (median: 36.0m, 95%CI:[31.0, 45.0] versus 12.0m, 95%CI:[11.0, 13.0];HR=1.71 [95% CI 1.54, 1.90] p  65y), UICC stage (I/II, III, IV), and histology (squamous, adenocarcinoma). The effect of treatment outside or within the CCCZ on patients’ survival remained significant (HR = 1.42 [95% CI 1.27, 1.57]; p  Conclusions Our analysis provides further evidence of the importance of the volume of experience and the availability of a multidisciplinary organisation and research environment, as delivered by a comprehensive cancer centre, on the outcome of patients with all stages of NSCLC. Legal entity responsible for the study Comprehensive Cancer Center Zurich. Funding Has not received any funding. Disclosure R.A. Stahel: Advisory / Consultancy: I have received honoraria as a consultant at advisory boards from AbbVie, AstraZeneca, Boehringer Ingelheim, MSD, Pfizer, Roche and Takeda.; Speaker Bureau / Expert testimony: I have received honoraria as a speaker from AstraZeneca, Boehringer Ingelheim, MSD and Roche.; Honoraria (self): Roche and Takeda; Research grant / Funding (institution), ETOP trials (president and scientific chair): AstraZeneca, BMS, Boehringer Ingelheim, Genentech, MSD, Roche, and Pfizer. All other authors have declared no conflicts of interest.