OG SSL Role
The OG SSL is part of the Royal College of Surgeons of England Clinical Research Initiative administered by the RCS and led by the RCS Director of Research, Professor Peter Hutchinson. The OG SSL works alongside other SSL’s who are now present in most surgical specialties. The OG SSL works most closely with the other AUGIS administered SSL’s in Pancreas and Colorectal Liver Mets. The agreed remit of the SSL’s is to:
- Transform surgical research in OG cancer
- Improve the lives of OG cancer patients
- Build capacity in surgical researchers of now and the future
- Design and deliver studies that address the key questions in the field
- Develop collaborations in cohorts to drive innovation
- Place AUGIS as a world-leading entity for OG surgical research
The OG SSL is subject to yearly appraisal with the RCS Director of Research and the President of the RCS.
Achievements of the OG SSL
I have been in this role since 2018. There has been considerable success across a broad portfolio linked to the remit defined above. Highlights include:
- A series of high-impact publications using the NOGCA dataset and the application of machine learning to predict survival outcomes and response to treatment
- Defining variation in pathological assessment of OG specimens and the impact on surgical quality indicators
- Consensus recommendations for the standardized histopathological reporting after radical OG surgery (HERO consensus)
- Work with the POQI consortium to produce the first consensus statement on intra and post-operative interventions to reduce pulmonary complications after oesophagectomy
- Complete and publish a multicentre cohort study of oesophageal injuries and related clinical outcomes (MUSOIC)
- Develop and deliver the ARROW study to assess variations in practice in antireflux surgery in the UK
- Secure NIHR funding for 2 large interventional clinical studies:
- SARONG (Surveillance After Resection of Oesophageal or Gastric cancer), £2.4 Million NIHR HTA. Pilot phase completed successfully
- GOLF (Linx versus standard antireflux surgery), £2 Million NIHR EME, in set up
Ongoing Activities
There are several work streams, some driven directly by the OG SSL programme and others that are supported by the OG SSL and AUGIS, these include:
- SARONG (see above)
- GOLF (see above)
- VALUE - NIHR RfPB funded assessment of variation in use of EUS in oesophageal cancer
- CONGRESS – A multicentre international collaborative cohort study on the management and outcomes of T1 oesophagogastric cancer
- TNT-OAC Trial - Total Neoadjuvant Treatment in Oesophageal Adenocarcinoma, under review with NIHR EME
- ORGAN Trial - Step-wedge cluster design registry-based randomised controlled trial of Open vs Robotic Gastrectomy for gastric AdeNocarcinoma, under review with NIHR HTA
Future Plans
The OG SSL programme has been extremely successful. It is now in a delivery phase for several large projects/programmes with others under assessment. Opportunity now exists for fresh thinking/ideas to build upon this platform. Future work should continue to develop the Upper GI (OG) academic workforce to help this delivery.
A meeting in 2024 to review and celebrate our success and then plan for the next phase of work is being considered.
Initial conversations and meetings have taken place about the formation of a UK Upper GI Surgical Trials Group with the intentions of capturing data lost with the ending of the NOGCA and rivalling the Dutch Upper GI trials group in terms of portfolio and delivery.
Partners/Key Personnel
Delivery of the OG SSL programme has only been possible due to the contributions of many people, including the AUGIS council, Heartburn Cancer UK and the RCS. Key people who have led or contributed directly to projects and ongoing programmes include:
- Sheraz Markar
- James Gossage
- Phil Pucher
- Rob Walker
- Marianne Holyman
- Natalie Blencoe
- Javed Sultan
June 2024