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Sankt Gallen, Switzerland

Putora P.M.,Kantonsspital St. Gallen | Ess S.,Cancer Registry St. Gallen Appenzell | Panje C.,Kantonsspital St. Gallen | Hundsberger T.,Kantonsspital St. Gallen | And 3 more authors.
Clinical and Experimental Metastasis | Year: 2015

Brain metastases from non-small cell lung cancer (NSCLC) are associated with a poor prognosis. In selected cases, surgical resection of brain metastases may be indicated, but the identification of patients suitable for surgery remains difficult. We collected data on patient and tumour characteristics known or suspected to be associated with survival by chart review. Data was merged with available data from the local cancer registry. We identified 64 NSCLC patients with resected brain metastases. Median overall survival after resection was 9.1 months with only two patients (3 %) surviving more than 71 and 80 months. One and 2-year survival were 42 and 12.5 %. Median survival for males and patients with more comorbidities was shorter (8 vs. 10 months [p = 0.11] and 6 vs. 9 months [p = 0.06]). Patients with squamous cell carcinomas (33 % of the patients) had a significantly worse survival than patients with other histologies (7 vs. 10 months [p = 0.02]) with no patient living longer than 2 years. Squamous cell histology was associated with worse prognosis after resection of brain metastases in patients with non-small cell lung cancer. Histology, among other parameters, may also be taken into account when choosing the appropriate patients for resection of brain metastases. © 2015, Springer Science+Business Media Dordrecht. Source

Ess S.,Cancer Registry St. Gallen Appenzell | Joerger M.,Cancer Registry St. Gallen Appenzell | Frick H.,Cancer Registry Grison Glarus | Probst-Hensch N.,Swiss Tropical and Public Health Institute | And 5 more authors.
Annals of Oncology | Year: 2011

Background: The aim of this study was to investigate predictors of state-of-the-art management of early breast cancer in Switzerland. Patients and methods: The study included 3499 women aged 25-79 years diagnosed with invasive breast cancer stages I-IIIA in 2003-2005. Patients were identified through population-based cancer registries and treated in all kinds of settings. Concordance with national and international recommendations was assessed for 10 items covering surgery, radiotherapy, systemic adjuvant therapy and histopathology reporting. We used multivariate logistic regression to identify independent predictors of high (10 points) and low (≤7 points) concordance. Results: In one-third of the patients, management met guidelines in all items, whereas in about one-fifth, three or more items did not comply. Treatment by a surgeon with caseload in the upper tercile and team involved in clinical research were independent predictors of a high score, whereas treatment by a surgeon with a caseload in the lower tercile was associated with a low score. Socioeconomic characteristics such as income and education were not independent predictors, but patient's place of residence and age independently predicted management according to recommendations. Conclusion: Specialization and involvement in clinical research seem to be key elements for enhancing the quality of early breast cancer management at population level. © The Author 2010. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source

Herrmann C.,Cancer Registry St. Gallen Appenzell | Herrmann C.,Swiss Tropical and Public Health Institute | Herrmann C.,University of Basel | Cerny T.,Kantonsspital St. Gallen | And 6 more authors.
BMC Cancer | Year: 2013

Background: Cancer survivors are a heterogeneous group with complex health problems. Data concerning its total number and growing dynamics for Switzerland are scarce and outdated.Methods: Population and mortality data were retrieved from the Swiss Federal Statistical Office (FSO). Incidence and relative survival for invasive cancers were computed using data from the cancer registries Geneva (1970-2009), St. Gallen - Appenzell (1980-2010), Grisons & Glarus (1989-2010), and Valais (1989-2010). We estimated prevalence for 1990-2010 using the Prevalence, Incidence Approach MODel (PIAMOD) method. We calculated trends in prevalence estimates by Joinpoint analysis. Projections were extrapolated using the above models and based on time trends of the period 2007-2010.Results: The estimated number of cancer survivors increased from 139′717 in 1990 (2.08% of the population) to 289′797 persons in 2010 (3.70%). The growth rate shows an exponential shape and was 3.3% per year in the period 2008 to 2010. Almost half of the survivors have a history of breast, prostate or colorectal cancer. Among cancer survivors, 55% are women but the increases have been more marked in men (p < 0.01, 3.9% annual increase in men vs. 2.7% in women since 2008). By the end of 2020 372′000 cancer survivors are expected to live in Switzerland.Conclusions: There is a rapidly growing population of cancer survivors in Switzerland whose needs and concerns are largely unknown. © 2013 Herrmann et al.; licensee BioMed Central Ltd. Source

Joerger M.,Cancer Registry St. Gallen Appenzell | Ess S.,Cancer Registry St. Gallen Appenzell | Savidan A.,Cancer Registry St. Gallen Appenzell | Bouchardy C.,Geneva Cancer Registry | And 3 more authors.
Swiss Medical Weekly | Year: 2012

BACKGROUND: There is considerable heterogeneity in the use of chemotherapy in early breast cancer (BC), despite international recommendations issued from the NCCN, NIH and the St.Gallen bi-annual conference. METHODS: We included 1,535 patients from seven Swiss cancer registries between 2003 and 2005 receiving chemotherapy for stage I to III BC. Chemotherapy was categorised into (a) FAC/FEC, anthracyclines followed by CMF or anthracycline-taxane combinations (FAC-T) (781 patients) and (b) other chemotherapy regimens such as CMF/AC (EC) (754 patients). Predictors for choosing FAC-T over non-FAC-T chemotherapy were separately determined in all patients and in ER-negative patients (n = 496) by multivariate logistic regression analysis. RESULTS: The use of FAC-T increased significantly over time, from 44% in 2003 to 55% in 2005. BC stage III (versus stage I-II) and nodal positivity were the predominant predictors for using FAC-T chemotherapy in the adjusted model (odds ratio (OR) 4.1, 95%-confidence intervals (CI) 2.6-6.3 and OR 3.0, 95%-CI 2.0-4.4, respectively). In high-risk ER-negative BC patients, poor histological differentiation was more important to choose FAC-T chemotherapy (OR 3.8, 95%-CI 1.9-7.5) than tumour stage or nodal status. The use of FAC-T chemotherapy varied substantially among the seven geographic regions, from 20% in rural Grisons-Glarus to 73% in Zurich. CONCLUSIONS: Tumour biology is a predominant factor for choosing FAC-T over older chemotherapy regimens in patients with ER-negative early BC, but improvements should be made to reduce the substantial regional heterogeneity. Further epidemiological studies should assess how the use of FAC-T chemotherapy is affecting clinical outcome in patients with early BC and different risk profiles. Source

Herrmann C.,Cancer Registry St. Gallen Appenzell | Herrmann C.,Swiss Tropical and Public Health Institute | Herrmann C.,University of Basel | Ess S.,Cancer Registry St. Gallen Appenzell | And 6 more authors.
BMC Cancer | Year: 2015

Background: In the past decades, mortality of female gender related cancers declined in Switzerland and other developed countries. Differences in the decrease and in spatial patterns within Switzerland have been reported according to urbanisation and language region, and remain controversial. We aimed to investigate geographical and temporal trends of breast, ovarian, cervical and uterine cancer mortality, assess whether differential trends exist and to provide updated results until 2011. Methods: Breast, ovarian, cervical and uterine cancer mortality and population data for Switzerland in the period 1969-2011 was retrieved from the Swiss Federal Statistical office (FSO). Cases were grouped into <55 year olds, 55-74 year olds and 75+ year olds. The geographical unit of analysis was the municipality. To explore age- specific spatio-temporal patterns we fitted Bayesian hierarchical spatio-temporal models on subgroup-specific death rates indirectly standardized by national references. We used linguistic region and degree of urbanisation as covariates. Results: Female cancer mortality continuously decreased in terms of rates in all age groups and cancer sites except for ovarian cancer in 75+ year olds, especially since 1990 onwards. Contrary to other reports, we found no systematic difference between language regions. Urbanisation as a proxy for access to and quality of medical services, education and health consciousness seemed to have no influence on cancer mortality with the exception of uterine and ovarian cancer in specific age groups. We observed no obvious spatial pattern of mortality common for all cancer sites. Rate reduction in cervical cancer was even stronger than for other cancer sites. Conclusions: Female gender related cancer mortality is continuously decreasing in Switzerland since 1990. Geographical differences are small, present on a regional or canton-overspanning level, and different for each cancer site and age group. No general significant association with cantonal or language region borders could be observed. © 2015 Herrmann et al. Source

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