Clinical trial NCT07022652: Influence of Hospital Volume on Mortality and Length of Hospital Stay After Oesophageal Cancer Resection in Switzerland
Official title: Influence of Hospital Volume on Mortality and Length of Hospital Stay After Oesophageal Cancer Resection in Switzerland: A Retrospective National Registry Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Esophageal Cancer
Lead sponsor: Cantonal Hospital of St. Gallen
Sponsor class: OTHER
First posted: 2025-06-15
Enrollment: 2880
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All patients with esophageal cancer resection in Switzerland between 2013 and 2022

Brief summary: The effect of centralisation measures on the operative outcomes after oesophageal cancer resection (ECR) in Switzerland has not been highlighted yet. Oesophageal cancer is a rare malignancy in Switzerland. It accounts for 2% of all cancers, with an incidence of 603 per year between 2017 and 2021, affecting primarily men (incidence per year 445, 74%). The mortality of oesophageal cancer is high. The 437 annual oesophageal cancer-related deaths between 2017 and 2021 result in a low 5-year overall survival (OS) of only 30%. Together with the often polymorbid patients, the very demanding surgical technique, and the challenges in postoperative management, a specialised, high-volume, interdisciplinary treatment team is required. The centralisation of such complex surgical procedures in specialised centres aims to build up such treatment teams, resulting in improved quality of the treatment and increased patient safety. To concentrate such procedures in Switzerland, the "Intercantonal agreement on highly specialized medicine" came into force in 2009. In 2013, esophagectomy was regulated for the first time, and the first service allocations were awarded definitely to eight and provisionally to another eight Swiss centres. Before 2013, esophagectomy was performed in 69 hospitals in Switzerland. The decision on the allocation was revised in 2019, resulting in only eight Swiss centres remaining with a service contract for esophagectomy. The next review will take place on the 31st of July 2025.

This retrospective registry study provides Swiss national data on the effect of centralisation on operative outcomes after oesophageal cancer resection (ECR) in Switzerland. It aims to measure the influence of the hospital-specific case number of ECR per year (hospital volume) on the outcome.


Eligibility criteria: Inclusion Criteria:

* Esophageal cancer resection

Exclusion Criteria:

* Incomplete documentation
* Age under 20 years
* Other hospitals than general or surgical hospitals
* No index operation

Primary outcomes:
measure: Mortality
timeFrame: Periprocedural
Secondary outcomes:
measure: Reoperation rate
timeFrame: Periprocedural
measure: Length of hospital stay
timeFrame: Periprocedural
measure: Sociodemographic trends
timeFrame: 2013 - 2022
Other outcomes:
Locations:
city: St.Gallen
country: Switzerland
facility: HOCH Health Ostschweiz, Kantonsspital St.Gallen
Study officials:
References: