Background: Despite the key role of optimized fasting in modern perioperative patient management, little current data exist on perioperative fasting intervals in routine clinical practice. Methods: In this multicenter prospective study, the length of pre- and postoperative fasting intervals was assessed with the use of a specifically developed questionnaire. Between 15 January 2021 and 31 May 2022, 924 gynecology patients were included, from 13 German gynecology departments. Results: On average, patients remained fasting for about three times as long as recommended for solid foods (17:02 ± 06:54 h) and about five times as long as recommended for clear fluids (9:21 ± 5:48 h). The average perioperative fasting interval exceeded one day (28:23 ± 14:02 h). Longer fasting intervals were observed before and after oncological or extensive procedures, while shorter preoperative fasting intervals were reported in the participating university hospitals. Smoking, treatment in a non-university hospital, an increased Charlson Comorbidity Index and extensive surgery were significant predictors of longer preoperative fasting from solid foods. In general, prolonged preoperative fasting was tolerated well and quality of patient information was perceived as good. Conclusion: Perioperative fasting intervals were drastically prolonged in this cohort of 924 gynecology patients. Our data indicate the need for better patient education about perioperative fasting.

Background: Effective communication improves patient satisfaction and reduces stress for both patients and physicians. Surveys consistently highlight the importance of strong communication skills among physicians, especially in oncologic settings. Yet, communication training is neither ubiquitous nor standardized in medical studies or residency, and physicians report that this task represents a burden for them. Given the limited data addressing the observations and expectations of patients with gynecologic malignancies when receiving bad news, this survey aimed to assess their perspective on this topic. Methods: We examined throughout an anonymous questionnaire how patients with gynecological and breast cancer experienced the delivery of bad news. Data were collected in Germany from July 2024 to September 2025. The questionnaire was available online and in paper form in four languages (German, English, Turkish, Arabic), with the purpose of recording culture-specific data. Results: A total of 249 patients completed the survey. Regarding the overall need for improvement in delivering bad news, 222 women (94.5%) declared that improvement was necessary, with 92 (39.1%) of them indicating that substantial improvement was required. While 67.9% of patients were content with the physician’s professional competence, 30.5% stated a lack of empathy, and 32.9% stated insufficient time for conversation. When comparing satisfied and dissatisfied patients, significant differences were observed across several aspects, such as consultation length, nonverbal communication, calmness of the setting, stress level after the conversation, and the offer to bring a trusted person or arrange a follow-up conversation. Conclusions: This patient survey highlights a persistent gap between patients’ expectations and physicians’ performance when it comes to delivering bad news. The findings underline the urgent need for the implementation of systematic training programs and structured communication protocols in gynecologic oncology.