Stomach and Oesophageal cancer audit reveals increased survival rates

A greater proportion of patients who have curative treatment for oesophageal or stomach cancer are living longer after diagnosis, according to new findings released today by the National Oesophago-Gastric Cancer Audit.

The Audit – commissioned by the Healthcare Quality Improvement Partnership and carried out by a partnership between AUGIS, the British Society of Gastroenterology, the Royal College of Radiologists, the Health and Social Care Information Centre and the Royal College of Surgeons of England – found that nearly 50% of patients with stomach tumours and around 45% of patients with an oesophageal tumour were still alive three years after diagnosis. Ten years ago, only about one third of patients survived longer than three years.

The audit is the largest of its kind in the world and collected data on more than 17,000 patients in England and Wales diagnosed between October 2007 and June 2009. It is the first time that national data on three year survival rates for this patient group has been published.

It shows that if patients are diagnosed early enough and have curative treatment, their chances of long-term survival are stronger.

The 2012 Annual Report of the National Oesophago-Gastric Cancer Audit – http://www.ic.nhs.uk/services/national-clinical-audit-support-programme-ncasp/audit-reports/oesophago-gastric-cancer – also highlights that the pattern of referral from general practice to hospital varies significantly by region in England and Wales. The proportion of patients who were diagnosed after an urgent GP referral ranged from 88 per cent to 38 per cent among the regional cancer networks.

In addition, 16 per cent of patients were diagnosed with cancer after an emergency hospital admission. These patients are less likely to benefit from treatment than patients diagnosed after a GP referral as the disease has advanced considerably.

Together, oesophageal and stomach cancers are the fourth most common cause of cancer death in the United Kingdom, affecting around 13,500 people each year.

The improved results outlined in the audit reflect better organisation of NHS cancer services in England and Wales. The centralisation of cancer services has allowed patients to have better access to the best available treatment. More than two-thirds (71%) of local hospitals have now combined multi-disciplinary team meetings with specialised hospitals, compared to one third (34%) five years ago. This has transformed patient care and surgery is now safer than it was 10 years ago.

Richard Hardwick, consultant surgeon and AUGIS member, said: “Survival of patients undergoing curative surgery for oesophageal or stomach cancerhas improved significantly. Our next challenge is to reduce the rates of complications following these major operations so that our patients recover more quickly from their surgery.”


 


AUGIS member gives Hunterian oration

AUGIS member Professor Alan Osborne, who works in Bristol gave a very well-received Royal College of Surgeons Hunterian Oration at the DDF in Liverpool, speaking on ‘Gut Hormones in Bariatric Surgery.’

Professor Osboure described a study to find out what happens to gut hormones after laparscopic RYGB which measured gut hormone changes post-operatively and changes to appetite and satiety. The results showed a significant decrease in hunger. He also looked at insulin resistance, diabetes adding and quality of life studies. He said: “Bypass surgery provides a fascinating model for the study of metabolic surgery but we need to look beyond weight loss and study diabetic outcomes.”

Prof Osborne also said that looking at the economic impact of surgery showed how bariatric operations saved millions of pounds. He referred to a study of 78 people which showed that before operations they had collectively worked 1,023 hours per week whilst after operations this figure rose to 1,611 hours, a 57% increase. Before bariatric surgery, the patients were claiming 32 different benefits but after surgery this dropped to eight. There was a 75% reduction in disability benefit claims.

Prof Osborne moved on to talk about the incidence of obesity in society compared with the number of bariatric trainee positions around the country He estimated that 50 new consultant posts would results in a £75 million economic saving.

In conclusion, he said: “Bariaric surgery is metabolic surgery. It is cost-effective – patients return to a normal quality of life – and it saves lives.”