Background: Surgery for rectal cancer has evolved, with the adoption of minimally invasive and robotic techniques. This study evaluates whether robotic surgery for rectal cancer produces an improvement in perioperative and oncological outcomes compared with open and laparoscopic surgery in a retrospective analysis. Methods: A single-center retrospective study included 212 patients with histologically confirmed rectal cancer treated between 2012 and 2021. The patients were grouped by surgical approach: robotic (RR, n = 62), laparoscopic (LR, n = 68), and open resection (OR, n = 82). The primary endpoints were total mesorectal excision (TME) quality, operative time, and hospital stay. The secondary endpoints included the lymph node yield, the conversion rate, and the 5-year survival outcomes (OS and DFS), analyzed via Kaplan–Meier curves and proportional hazards models. Results: The TME quality was high across the groups (RR: 91.9%, LR: 86.8%, OR: 95.1%). The median operative time was the longest in the RR group (304 min vs. 221–222 min in LR/OR). Robotic surgery resulted in shorter median hospital stays (10 (RR) vs. 14 (LR) vs. 14 (OR) days) and a lower conversion rate (3.2% vs. 14.7% in LR). The lymph node yield was highest in the LR group (27.9), followed by the RR (25.5) and OR (23.0) groups. Postoperative pneumonia was most common in the OR group (12.2%), and bladder dysfunction occurred only in the OR group (4.9%). The five-year OS and DFS did not differ notably between the groups. Conclusions: Robotic surgery offers advantages in short-term outcomes, including fewer complications, shorter hospitalization, and lower conversion rates, despite longer operative times. Its oncological efficacy is equal compared to those of laparoscopic and open surgery.

Evidence on the recent temporal trend in the incidence and mortality of early-onset cancer, i.e., cancer diagnosed at ages of < 50 years, in Germany is scarce. To estimate the temporal trend in the incidence and mortality of early-onset cancer in Germany between 1999 and 2019. Input data were obtained from the Centre for Cancer Registry Data (Zentrum für Krebsregisterdaten, ZfKD). The analysis comprised all ages until 50 years and all types of cancer classified by the International Classification of Diseases (ICD-10)-codes C00-C97 (excl. C44). Temporal trends were estimated using negative binomial regression, differentiated by sex and cancer type. Between 1999 and 2019 in Germany, we observed stable or slightly increasing trends (0% and 1%) in the incidence of all early-onset cancers combined (C00-C97) for men and women, respectively, and strict declines in the mortality for both, men and women (-2% and − 3%). However, the trends differ largely with respect to sex and the individual cancer types. Early-onset cancer should be closely monitored to see whether stable and decreasing trends in the incidence and mortality continue. Knowing that despite decreasing incidence, the prevalence of a disease can rise due to their interplay with mortality, we recommend to maintain precise surveillance, efforts in prevention and early detection, as well as appropriate investments into healthcare resources, research and development.

Background: Many cancer survivors (i.e., individuals alive who have been diagnosed with cancer at some point in their lives) remain under surveillance by doctors and medical professionals regardless of the outcome of their treatment as they face the risk of recurrence and/or encounter symptoms and other health-related issues. With advancements in cancer early detection, diagnostics, and treatment strategies, along with an increasingly older population, the number of cancer survivors is steadily increasing. Since information on epidemiological indicators of cancer survivors is limited in Germany, the present study aims to estimate its prevalence between 2010 and 2019. Methods: The annual age- and sex-specific lifetime prevalence of cancer was estimated using a partial differential equation. The calculation was based on comprehensive data obtained from the Centre for Cancer Registry Data (Zentrum für Krebsregisterdaten, ZfKD), the Central Research Institute of Ambulatory Health Care in Germany (Zentralinstitut für die kassenärztliche Versorgung, Zi), and the German Federal Statistical Office. Results: Our estimates indicate a rise in lifetime prevalence of cancer between 2010 and 2019 across all ages up to 85, particularly pronounced among older individuals. By 2019, the highest prevalence was estimated to be 49% of males and 28% of females at age 85. In contrast, childhood cancer was relatively rare, affecting less than 0.3% of girls and boys until the age of 18. Generally, the prevalence of cancer was higher among males than females. Overall, the number of cancer survivors aged up to 85 was estimated to increase from 2.51 million in 2010 to over 5.07 million in 2019. Conclusions: The findings indicate a substantial rise in the lifetime prevalence of cancer in 2019 compared to 2010. Considering a cancer patient as cured based on a specific timeframe may lead to an underestimation of the future demand for healthcare resources.

The global prevalence of multiple sclerosis has shown a marked rise in recent decades, with Germany reporting the highest prevalence among European countries. This study aims to project the future number of people with multiple sclerosis in Germany until 2040 which is necessary for effective resource allocation and health care planning. Based on data from the German statutory health insurance, the age- and sex-specific prevalence of multiple sclerosis was estimated applying mathematical relations between prevalence, incidence rate, and mortality rate. Subsequently, the projected prevalence was applied to the age structure of the German population between 2015 and 2040 to calculate the future number of people with multiple sclerosis. Several temporal trend scenarios pertaining to the incidence and mortality rate were compared. Application of current age-specific prevalence estimates combined with the projected population structure in 2040, results in a decline of 8% in the number of people with multiple sclerosis. More realistic scenarios that reflect on trends in mortality and incidence rates, project between 453,000 (+75%) and 477,000 (+85%) multiple sclerosis cases in 2040. It is expected that females will be affected nearly 2.5 times more frequently than males in 2040. The findings indicate a substantial rise in the prevalence of multiple sclerosis, ranging from 75% to 85% in 2040 compared to 2015. Assuming a constant age-specific prevalence between 2015 and 2040 without any temporal trends in mortality and incidence rates may underestimate the actual number of cases and consequently, future requirements for healthcare resources.

Background/Objectives: Minimally invasive approaches are increasingly used in right colectomy for colon cancer; however, comparative data, including open, laparoscopic, and robotic techniques, remain limited, particularly regarding postoperative recovery and oncological outcomes. Methods: This retrospective monocentric study included 89 patients undergoing elective right colectomy for colon cancer between July 2018 and December 2022. Of these, 30 patients underwent open, 29 laparoscopic, and 30 robotic-assisted surgery. The primary endpoint was postoperative recovery, defined as the time to first bowel movement. Secondary endpoints included length of hospital stay, complete mesocolic excision (CME) quality, lymph node yield, C-reactive protein (CRP) on postoperative day one, operative time, overall survival (OS), and disease-free survival (DFS). Multivariable regression analyses were performed adjusting for age, sex, BMI, ASA score, UICC stage, and tumor size. Results: Time to first bowel movement was shorter after minimally invasive surgery (median robotic 3.5, laparoscopic 4 vs. open 5 days) and length of hospital stay was numerically shorter (mean 9.1 vs. 10.1 days). CME quality and lymph node yield did not differ significantly between the approaches, and postoperative day-one CRP was numerically lower after robotic (median 4.9 mg/dL) and laparoscopic (5.1 mg/dL) than after open surgery (7.1 mg/dL), without reaching statistical significance after adjustment. Operative time was significantly longer with minimally invasive surgery (robotic +50 min; laparoscopic +43 min vs. open; both p < 0.001). Disease-free (open 51.6%, laparoscopic 66.5%, robotic 66.9%) and overall survival did not differ significantly after adjustment (robotic HR 1.16; laparoscopic HR 1.01 vs. open). Conclusions: No statistically significant difference in surgical quality between the approaches was detected, while operative time was significantly longer after minimally invasive surgery. No statistically significant independent association between the surgical approach and postoperative recovery or three-year oncological outcomes was detected; given the limited precision of the estimates, clinically important differences cannot be excluded.