[Effects of the Minimum Volume Requirement in Surgical Lung Cancer Therapy - an Analysis from the Patient's Perspective].

Abstract

Due to a legislative decision, a minimum volume for the surgical treatment of lung cancer has been applied since the beginning of 2024 in Germany. This has led to a change in care structure, with the result that some patients are now being treated further away from home in an unfamiliar environment.Patient survey using standardised questionnaires, descriptive analysis of results.No more anatomical lung resections were performed at the Donau Isar Klinikum in 2024, as a consequence of the minimum volume requirement. Since then, these procedures have been performed at the Clinic for Thoracic Surgery at the Munich Bogenhausen Clinic, a certified lung cancer centre. 68% of patients (n = 25) felt sufficiently informed in advance about why their operation could not be performed near their home. 80% of respondents had not heard about the new regulation beforehand. The fact that they would be operated on in a certified centre, but would have to travel a longer distance, provided reassurance among those affected (60%; 84% among relatives), but also uncertainty (24%), incomprehension (20%) and anger (12%). The average distance to the lung cancer centre was 143.4 km (∅ 1 h 48 min). All patients were satisfied with the contact and appointment process (1: very dissatisfied/10: very satisfied, ∅ 9.3), the information about the procedure (∅ 9.4), the overall stay (∅ 9.2), the medical and nursing treatment (∅ 9.7/9.3) and the rooms and catering (∅ 8.6). The majority (76%) did not experience the longer return journey as stressful. The communication and cooperation between the primary treating physicians and the lung cancer centre was rated as good; almost all would recommend the lung cancer centre.The feedback from the patients affected by the changed guidelines was positive. The perceived safety and quality of treatment at a centre of excellence compensated for the existing uncertainty about the unfamiliar environment and the disappointment about the associated inconvenience. Although the insights gained must be confirmed by an ongoing survey and the experiences of other centres, the concept of centring complex interventions in the field of surgical lung cancer therapy appears to be supported by those affected.