Transcript Slide 1

Clinical T1 Cancers
S Wahed
OG NSSG Audit Day
6 November 2013
RVI
• N = 30; resections only
Oesophageal
(12)
Gastric (18)
Weight loss
Epigastric discomfort
Vomiting
Odynophagia
2
2
2
1
3
8
4
0
Nausea
Reflux
Difficult swallowing
Barrett’s surveillance
1
3
2
10
2
2
3
0
Anaemia
0
2
RVI - Oesophagus
• N = 12
– 11 lower third,
– 2 middle third
• Median age 63
– range 41 – 76
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M:F 8:4
All EUS
CT-PET 1
Bone scan 1
• EMR  surgery 5
• Surgery 7
– Neoadj 1 (cT1 N1)
• All pT1 N0
RVI - Gastric
• N =18
• Median age 71.5
– range 41-81
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M:F 11:7
Cardia 3
Fundus 1
Body 1
GC 3
LC 3
Antrum 2
Pylorus 1
• CT all
– 5 N1
• EUS 12
– 2 N1
• PET 1
• Bone scan 2
• Laparoscopy 5
– node positive on CT or EUS 4
RVI - Gastric
• EMR 1
• Neoadj 3 (node
positive)
• TG 7
• STG 9
• Merindino 2
RVI – Gastric Resections
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HGD
11 x pT1 N0
3 x pT2 N0
pT1 N1
pT2 N3 (neoadj)
pT3 N1 (?emergency
obstruction)
• ACA 16
• Small cell
neuroendocrine 1
• HGD 1
JCUH
• N = 20; includes non-resections
• May 2012 – April 2013
Oesophageal
Gastric
2WW
7
1
Barrett’s
8
0
JCUH - Oesophageal
• N = 17
• Median age 70
– range 52-98
• M:F 11:6
• Surgery 4
• EMR 4
– +1 surgery
– +1 CRT
• Chemorad 5
• EUS 2
– SCC 3, AC 1, HGD 1 (?)
• Pall DXT 1 SCC
• BSC 2
• Refer 1
JCUH - Oesophageal
• Resections
– 3 pT1 N0 AC
– 1 HGD
• EMR
– 3 HGD
– 1 T1 N0 AC
JCUH - Gastric
• N=3
• Median age 70
– range 60-80
• M:F 2:1
• Gastric
– Surgery 2
• 1 lap, 1 open
– Polypectomy 1
JCUH - Gastric
• Resections
– pT1b N0
– HGD
• Polypectomy
– AC
Conclusion
• Early cancers relatively small proportion of
cases
• Early oesophageal cancers are picked up on
Barrett’s surveillance
• Surgery is most common treatment modality
• Histology appears to confirm accurate staging
Acknowledgements
• Helen Jaretzke & Angela Tate
• Helen Wescott