Influence of Hospital Volume on Mortality and Length of Hospital Stay After Oesophageal Cancer Resection in Switzerland

NCT07022652 | Completed

• 1 other identifier: Hospital volume in ECR
• Study Type: observational
• Target: 2,880
• Locations: 1 country
• Sites: 1

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.

Conditions

Esophageal Cancer

Outcome Measures

Primary Outcomes (1)

• Mortality

  The association between the hospital volume and the postoperative mortality Mortality Yes or No Hospital volume of esophageal cancer resection as marginal effect Association with GAM logistic regression

  Periprocedural

Secondary Outcomes (3)

• Reoperation rate

  Periprocedural

• Length of hospital stay

  Periprocedural

• Sociodemographic trends

  2013 - 2022

Interventions

Esophageal cancer resection PROCEDURE

Esophageal cancer resection

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients with esophageal cancer resection in Switzerland between 2013 and 2022

You may qualify if:

• Esophageal cancer resection

You may not qualify if:

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

Sponsors & Collaborators

• Cantonal Hospital of St. Gallen: lead

Study Sites (1)

HOCH Health Ostschweiz, Kantonsspital St.Gallen

Sankt Gallen, St.Gallen, 9000, Switzerland

Location

MeSH Terms

Conditions

Esophageal Neoplasms

Condition Hierarchy (Ancestors)

Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Head and Neck Neoplasms; Digestive System Diseases; Esophageal Diseases; Gastrointestinal Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 90 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 26, 2025
• First Posted: June 15, 2025
• Study Start: January 1, 2013
• Primary Completion: December 31, 2022
• Study Completion: May 15, 2025
• Last Updated: June 15, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)