e13855 Background: Geriatric oncology (GO) addresses the unique needs of older cancer patients, an increasingly critical population as the demographic shift towards aging continues. However, evidence gaps and a lack of standardized guidelines hinder the integration of GO into daily oncology practice. We conducted a comprehensive survey among physicians evaluate the current status of geriatric oncology in Switzerland . identify positive aspects as well as barriers. Methods: A structured questionnaire was disseminated to approximately 300 oncology professionals including hematologists, pathologists, gynecologic oncologists via email through the Swiss Group for Clinical Cancer Research (SAKK) between July and September 2024. Anonymous responses were collected using MS Forms with follow-up at the SAKK semi-annual meeting. The survey assessed baseline characteristics, utilization of GO guidelines, screening practices, and perceptions regarding the benefits and barriers to implementing GO in clinical settings. Results: A total of 100 responses were analyzed (response rate: > 30%). Key findings include: Participant Profile: 55% female; 45% male. Predominantly professionals managing solid tumors, with 50% utilizing GO guidelines. The majority of participants were senior specialists ( > 10 years of clinical experience). Screening Practices: The G8 tool was the most frequently used (45/68), primarily for patients aged > 65 with geriatric syndromes or > 75 years. Benefits of GO Assessments: Improved treatment personalization (69 mentions), quality of life (61 mentions), and decision-making accuracy (58 mentions) were cited as key advantages. Barriers: Personnel and expertise shortages were noted by 48% of respondents, alongside limited interest in GO workshops and insufficient healthcare policy support. Clinical Impact: Treatment modifications following GO assessments were reported occasionally (85%) or often (8%), with frequent exclusion of chemotherapy when inappropriate. Research Interests: High interest was observed in research domains like gynecological oncology, hematology, and surgery. Conclusions: While Switzerland has a robust network of experienced oncology professionals and supportive services, the integration of GO remains inconsistent and sparse. Addressing barriers such as personnel training, policy frameworks, and fostering research collaboration is essential. Initiatives to promote early education in GO, advocate for patient-centered care, and establish national consensus standards are critical next steps. These efforts will position Switzerland as a leader in geriatric oncology amidst a rapidly aging European population. Future Directions: The Swiss Geriatric Oncology Group (SGOG) aims to expand its efforts in education, research, and policy advocacy to bridge gaps in the implementation of GO, ensuring optimal care for older cancer patients.
BackgroundCalcaneal slide osteotomies represent a well-established component in the surgical treatment of joint-preserving hind foot corrections. The percutaneous technique aims to minimize the surgical morbidity and maximize surgical efficiency. There is a consensus that percutaneous calcaneal sliding osteotomy (PCSO), using a low-speed and hightorque burr, is generally performed in four steps corresponding to the four quadrants of the cross-section of the calcaneal tuber. We present a technique that allows a more efficient osteotomy by cutting the far cortex in one step using standard percutaneous equipment. The aim of this study is to present preliminary results and the surgical technique of a modification for percutaneous calcaneal sliding osteotomy.Materials and MethodsBetween June 2016 and March 2023, a total of 101 percutaneous calcaneal slide osteotomies were performed using the Rising Sun Technique. Prospective clinical and radiologic evaluation was completed for 70/101 cases (69.3%). Complications were classified according to the modified Clavien-Dindo-Sink Classification (CDS I-III). For the last 25 cases, additional information on surgery duration and use of fluoroscopy was available. The results of two surgeons (S1, S2) with different MIS experiences were compared to determine surgical proficiency.ResultsThe mean follow-up was 36 months (range 12-73 months). In 46 cases the underlying deformity was a planovalgus and in 24 a cavovarus deformity. In total, there were 5/70 (7.1%) surgery-related complications, three cases needed revision surgery: 2 patients required superficial surgical wound revision for disturbed wound healing, 1 patient requested screw removal due to discomfort related to the hardware after 15 months. The mean surgery duration for both surgeons combined was 19.6 min, and the average number of fluoroscopies was 20.2.ConclusionsCompared to traditional open calcaneal slide osteotomies, PCSO helps to reduce softtissue morbidity and may result in fewer surgery-related complications. The Rising Sun procedure of PCSO represents a safe and easy-to-perform alternative to the traditional 4-quadrants technique in the percutaneous correction of hindfoot malalignment. Our prospective case series showed a low rate of complications and reproducible surgery time and use of fluoroscopy.
