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Introduction: The small-scale healthcare in Saxony-Anhalt is described as disparate, as regions with good healthcare structures and increasingly undersupplied regions face each other. Deficits in cross-sectoral therapy management jeopardizes ambulatory care after hospital stay in rural areas. This study aims to analyze cross-sectoral care trajectories of patients with colorectal cancer in Saxony-Anhalt over the period from diagnosis up to one year post-discharge and to identify differences in care between patients from urban vs. rural regions. Routine data of the statutory health insurance were used for this study., Methods: The study population comprised 13,218 insured patients of AOK Saxony-Anhalt with colorectal cancer treated in 2010-2014. Services billed by hospitals and outpatient physicians were considered in relation to patients' residence (urban vs. rural). Survival times were determined according to Kaplan & Meier and explanatory variables for survival were analyzed using regression analysis according to the Cox proportional hazards model., Results: Differences between urban and rural regions were evident in the use of certified hospitals and outpatient treatment. In addition, an undersupply of adjuvant or neoadjuvant treatment became apparent, so that compliance with the guidelines can only be assumed to a limited extent. Overall survival was significantly higher in patients living in urban regions as compared to those from rural areas, which is mainly due to earlier diagnosis, younger age, fewer comorbidities and more adequate cancer therapy., Conclusion: There is an urgent need to optimize healthcare structures and processes to enable early diagnosis and barrier-free use of adequate therapies., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Radiotherapy is an integral component of most modern multimodal tumor treatment concepts, both in palliative and curative situations and intentions. This also applies to many tumor entities relevant in general as well as abdominal surgery. This can give rise to new challenges in the context of the daily clinical routine and interdisciplinary tumor conferences., Aim: Practice relevant overview, based on selective references from the current scientific literature in medicine and own experiences obtained in daily work, for the oncological surgeon on radiotherapy-associated options for visceral tumor lesions. A particular focus is on rectal cancer, esophageal cancer, anal cancer and liver metastases., Method: A narrative review is given., Results (selected Corner Points): In total neoadjuvant therapy it is possible to avoid resection in rectal cancer if a good response is achieved and close monitoring can be provided. In esophageal cancer neoadjuvant chemoradiotherapy followed by resection can be considered the therapeutic regimen of choice for all suitable patients. If surgery is not an option, definitive chemoradiotherapy is an appropriate and favorable alternative, especially with respect to squamous cell carcinoma. Even taking the latest data on the topic into account, definitive chemoradiotherapy remains undisputedly recommended for anal cancer. Liver tumors can be locally ablated by stereotactic radiotherapy., Conclusion: Close cooperation between disciplines in the context of tumor therapy remains essential for the best possible treatment and outcome of patients., (© 2023. The Author(s).)