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Background <p>Cancer therapy-related cardiovascular toxicity (CTR-CVT) is a leading non-cancer cause of morbidity and mortality in oncology patients. Implementation of the 2022 ESC Guidelines on cardio-oncology in German inpatient care remains poorly characterised.</p> Methods <p>Cross-sectional online survey of 1,435 German hospital departments (February–October 2025). Cardiologists, internists, gynaecologists and oncologists answered items on risk stratification, diagnostics, biomarkers, communication and care quality.</p> Results <p>120 physicians responded (cardiologists 36.7%, oncologists 23.3%, gynaecologists 22.5%, internists 17.5%; 73.3% academic/university hospitals). Pre-chemotherapy risk stratification was reported by 85.4% of oncologists and gynaecologists, yet cardiologists were involved in only 28–35%, with heterogeneous risk parameters across specialties. Pre-chemotherapy N-terminal pro-B-type natriuretic peptide (NT-proBNP) use ranged from 85.3% (cardiology) to 15.8% (gynaecology; p &lt; 0.001); 52.6% of gynaecologists used no biomarker. In high-risk patients (anthracyclines plus pre-existing heart failure), gynaecologists monitored significantly less than oncologists at every time point, with 12-month surveillance at 5.3% versus 54.2% (<i>p</i> = 0.001); acute cardiac events were the predominant trigger (36.8%), reflecting reactive rather than proactive practice. Cardiological co-management was median 100% (IQR 50–100) in gynaecology versus 70% (IQR 30–100) in oncology. Dedicated cardio-oncology boards existed in only 1.3% of institutions despite &gt; 70% endorsement; median perceived deficit to optimal care was 50–63%. Top-requested interventions were digital risk-stratification tools (up to 81.8%) and interdisciplinary continuing education (up to 72.7%).</p> Conclusion <p>This survey shows that, among participating hospitals, inpatient cardio-oncology care had substantial guideline–practice gaps. Structured solutions were broadly endorsed: digital risk-stratification tools, post-treatment surveillance and cardio-oncology boards are concrete implementation targets.</p> Graphical abstract <p></p>

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Cardio-oncology care in German hospitals: a multicentre inpatient survey of practices, perceptions and guideline gaps

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月27日

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  • S. Poley,
  • L. Payo-Anez,
  • F. M. Heidrich,
  • J. Schmitt,
  • K. Ibrahim,
  • M. Kösters,
  • M. Christoph,
  • T. Haase,
  • J. Hamann,
  • L. Harst,
  • S. Quick

摘要

Background

Cancer therapy-related cardiovascular toxicity (CTR-CVT) is a leading non-cancer cause of morbidity and mortality in oncology patients. Implementation of the 2022 ESC Guidelines on cardio-oncology in German inpatient care remains poorly characterised.

Methods

Cross-sectional online survey of 1,435 German hospital departments (February–October 2025). Cardiologists, internists, gynaecologists and oncologists answered items on risk stratification, diagnostics, biomarkers, communication and care quality.

Results

120 physicians responded (cardiologists 36.7%, oncologists 23.3%, gynaecologists 22.5%, internists 17.5%; 73.3% academic/university hospitals). Pre-chemotherapy risk stratification was reported by 85.4% of oncologists and gynaecologists, yet cardiologists were involved in only 28–35%, with heterogeneous risk parameters across specialties. Pre-chemotherapy N-terminal pro-B-type natriuretic peptide (NT-proBNP) use ranged from 85.3% (cardiology) to 15.8% (gynaecology; p < 0.001); 52.6% of gynaecologists used no biomarker. In high-risk patients (anthracyclines plus pre-existing heart failure), gynaecologists monitored significantly less than oncologists at every time point, with 12-month surveillance at 5.3% versus 54.2% (p = 0.001); acute cardiac events were the predominant trigger (36.8%), reflecting reactive rather than proactive practice. Cardiological co-management was median 100% (IQR 50–100) in gynaecology versus 70% (IQR 30–100) in oncology. Dedicated cardio-oncology boards existed in only 1.3% of institutions despite > 70% endorsement; median perceived deficit to optimal care was 50–63%. Top-requested interventions were digital risk-stratification tools (up to 81.8%) and interdisciplinary continuing education (up to 72.7%).

Conclusion

This survey shows that, among participating hospitals, inpatient cardio-oncology care had substantial guideline–practice gaps. Structured solutions were broadly endorsed: digital risk-stratification tools, post-treatment surveillance and cardio-oncology boards are concrete implementation targets.

Graphical abstract