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How can we improve the interoperability of medical guidelines and the implementation and measurement of outcomes in medical health care for cancer patients as well as for care providers? This is the aim of the working group "Quality and Cross-linking". The following publication gives an overview of the targets reached in the development of guidelines together with quality indicators and documentation in cancer registries., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Background: Lip, oral cavity, and pharynx cancers (ICD-10: C00-C14) describe a heterogeneous group of tumors with strong variations in incidence, mortality, and survival by entity., Objectives: This work provides a detailed overview of epidemiologic measures for these tumor entities, taking into account heterogeneity in age, sex, location, and stage., Material and Methods: Incidence and mortality data for Germany for the years 1999-2016 were extracted from the interactive database of the Center for Cancer Registry Data (ZfKD). Age and stage distributions and five-year relative survival were calculated on the pooled ZfKD data set (diagnosis years 1999-2017)., Results: In 2016, overall incidence and mortality for all entities were 17.6 and 7.0 per 100,000 men and 6.5 and 1.8 per 100,000 women, respectively. The five-year relative survival in 2015-2017 was 53 and 63%, respectively. There were marked differences in survival as well as age and stage distributions between entities. Trend analyses showed an increase in age at diagnosis, particularly in male patients, and no change in stage distributions. However, five-year relative survival increased from 45% (men) and 59% (women) in 1999-2002 to 52% and 63% in 2013-2017., Conclusion: The marked heterogeneity of the studied tumors highlights the need to differentiate the analysis by sex and entity for meaningful interpretation of epidemiologic metrics. With the expansion of clinical cancer registration in Germany, additional analyses including other important clinical factors will be possible in the future., (© 2021. The Author(s).)

Introduction: We investigated how many cancer survivors receive psycho-oncological care in hospitals and outpatient cancer counselling centres and which factors influence usage., Methods: Long-term survivors of breast, colon or prostate cancer completed a questionnaire assessing the use of psycho-oncological services in the "Cancer Survivorship--a multiregional population-based study (CAESAR)". Gender, age, community size, education, income and stage of disease were investigated as potential predictors of use., Results: Out of 6,143 participants, 547 (9%) reported having received psycho-oncological support in the hospital, 183 (3%) had visited a counselling centre. Inpatient services were more frequently used by higher educated persons (OR 1.5), women (OR 1.3), and patients with advanced disease (OR 1.3); less frequently by older survivors (OR 0.6). Community size and income were not related to inpatient use. Counselling centres were visited more frequently by women (OR 2.2), higher educated survivors (OR 2.1), patients with advanced disease (OR 1.6), and participants from communities with >100,000 inhabitants (OR 2.4); less frequently from elderly OR 0.4)., Discussion: Especially the use of outpatient cancer counselling centres was associated with contextual and individual factors whereas this was not so much the case with the use of inpatient services. This implies that care models where psycho-oncologists actively approach patients are better able to access all patient groups in contrast to care models where patients have to actively seek help. It also implies that non-use not necessarily means that patients do not need help but that there are barriers to health care access., (© Georg Thieme Verlag KG Stuttgart · New York.)

Blood pressure, heart rate and perspiration were and still are the only clinical signs for recognizing the depth of balanced anaesthesia in combination with muscle relaxants. Even experienced anaesthetists sometimes have difficulties in recognizing the necessary depth of anaesthesia using these parameters and in relatively rare cases the very unpleasant symptom of awareness occurs. Nowadays, processed EEG monitoring (pEEG) is used scientifically and also clinically for exact controlling of general anaesthesia. We report on our first experience with this method in 21 patients who were anaesthetized with propofol, alfentanil and nitrous oxide and relaxed with atracurium and whose depth of anaesthesia was carefully controlled by pEEG using the pEEG Monitor of Drägerwerke. The following parameters were recorded continuously: Spectral Edge Frequency (SEF) 50, SEF 90, SEF 95 and power between 8 and 20 Hz in relation to the power between 0 and 4 Hz (delta ratio). In agreement with other investigators we found that a sufficient depth of anaesthesia could be expected when the SEF 50 ranged between 2 and 6 Hz (4.9 +/- 0.9), the SEF 90 ranged between 10 and 13.5 Hz (11.9 +/- 0.6), the SEF 95 ranged between 14 and 16 Hz (14.8 +/- 0.8) and the delta-ratio ranged between 0.7 and 1.4 (1.1 +/- 0.2). Using this anaesthetic technique and a premedication with benzodiazepine, SEF 90 SEF 95 are the best parameters for monitoring the depth of anaesthesia. In one patient blood pressure and heart rate remained constant intraoperatively, but she described intensive dreams postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)