In the context of the advancements in new anticancer drugs, the trends in multidisciplinary cancer care and the focus towards patient-centred outcomes, assurance of quality needs to evolve. This... Show moreIn the context of the advancements in new anticancer drugs, the trends in multidisciplinary cancer care and the focus towards patient-centred outcomes, assurance of quality needs to evolve. This thesis aims to investigate how quality could be assured facing these trends. Part I showed that gastric cancer patients with severe postoperative complications had an increased likelihood of adjuvant chemotherapy omission. It would therefore be valuable to discuss such multidisciplinary quality measures in multidisciplinary team meetings. Part II demonstrates that registries like the Dutch Melanoma Treatment Registry (DMTR) are valuable in the era of immunotherapies and targeted therapies. First results demonstrate that the new drugs for metastatic melanoma have been safely introduced with comparable toxicity rates as reported in the pivotal trials. However, in patients with multiple risk factors, targeted therapy with vemurafenib has a low probability of benefitting the patient. Registries like the DMTR are therefore important to inform policy makers whether interventions work in real world. A wider recognition of cancer care as a chronic disease, including the collection of patient-reported outcomes measures is required in quality assessment. In Part III we describe a patient-centered outcome set for breast and colorectal cancer of which the majority is patient reported. Show less
