One-year survey of carcinoma of the oesophagus and stomach in Wales

Pye, J. K.; Crumplin, M. K. H.; J, Charles; Kerwat, Rajab; Foster, M. E.; Biffin, A.

doi:10.1046/j.1365-2168.2001.01655.x

Cited by 62 publications

(39 citation statements)

References 34 publications

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“…In 1995, an audit of all cases diagnosed with oesophagogastric cancer in Wales found the incidence of oesophageal cancer to be 11/ 100 000 (Pye et al, 2001). Based upon this data, Velindre Cancer Centre serving South East Wales with a population of 1.48 million people would expect to see 165 patients per year with this disease.…”

Section: Discussionmentioning

confidence: 99%

“…However, despite better staging and improving perioperative care, the outcome from this treatment remains poor, with 30 -45% patients surviving 2 years after radical resection (Kelsen et al, 1998;Medical Research Council Oesophageal Cancer Working Group, 2002). The proportion of patients for whom this treatment is selected varies in different countries from 25 to 45% (Fok et al, 1994;Coia et al, 2000;Pye et al, 2001). This complex surgery is challenging for both the surgeon and the patient; between 5 and 10% will die as a result of an oesophagectomy and 30 -40% will suffer significant postoperative morbidity.…”

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Definitive chemoradiation in patients with inoperable oesophageal carcinoma

et al. 2004

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We performed a retrospective study of 90 consecutive cases with inoperable carcinoma of the oesophagus treated with definitive chemoradiation at a single cancer centre between 1995 and 2002. For the last 4 years, 73 patients have received therapy according to an agreed protocol. This outpatient-based regimen involves four cycles of chemotherapy, cycles 3 and 4 given concurrently with 50 Gy external beam radiotherapy (XRT) delivered in 25 fractions over 5 weeks. Cisplatin 60 mg m À2 day À1 is given every 3 weeks together with continuous infusional 5-fluorouracil 300 mg m À2 day À1 , reduced to 225 mg m À2 day À1 during the XRT. In all, 45 (50%) patients suffered one or more WHO grade 3/4 toxicity, grade 3 in 93% cases. Patients received more than 90% of the planned chemoradiation schedule. The median overall survival was 26 (15, 496) months, 51% (41, 64) and 26% (13, 52) surviving 2 and 5 years, respectively. Advanced stage, particularly T4 disease, was associated with a worse prognosis. Patients considered not suitable for surgery for reasons other than their disease, mainly co-morbidity, had a significantly better outcome, median survival 40 (26, 496) months, 2-and 5-year survivals 67% (54, 84) and 32% (13, 79), respectively (Po0.001). This schedule is a feasible, tolerable and effective treatment for patients with oesophageal cancer considered unsuitable for surgery.

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Definitive chemoradiation in patients with inoperable oesophageal carcinoma

et al. 2004

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“…Thorough and accurate staging of patients is of paramount importance in the selection of patients for whom surgery could be potentially curative [4].The recent large regional audit of esophagogastric cancer in Wales revealed that many surgeons continue to undertake small caseloads; staging laparoscopy was performed in 16% of cases; and no fewer than 23% of patients underwent open-and-close operations [3]. Staging protocols for patients with gastric cancer vary, not only from hospital to hospital within the United Kingdom, but from east to west worldwide.…”

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confidence: 99%

“…Despite the introduction of open access gastroscopy, as many as one in three British patients continue to present with advanced disease that is incurable by means of surgery [2,3]. Thorough and accurate staging of patients is of paramount importance in the selection of patients for whom surgery could be potentially curative [4].…”

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“…

The recent large regional audit of esophagogastric cancer in Wales revealed that many surgeons continue to undertake small caseloads; staging laparoscopy was performed in 16% of cases; and no fewer than 23% of patients underwent open-and-close operations [3].

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Laparoscopy significantly improves the perceived preoperative stage of gastric cancer

et al. 2003

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Despite the introduction of open access gastroscopy, as many as one in three British patients continue to present with advanced disease that is incurable by means of surgery [2,3]. Thorough and accurate staging of patients is of paramount importance in the selection of patients for whom surgery could be potentially curative [4].The recent large regional audit of esophagogastric cancer in Wales revealed that many surgeons continue to undertake small caseloads; staging laparoscopy was performed in 16% of cases; and no fewer than 23% of patients underwent open-and-close operations [3]. Staging protocols for patients with gastric cancer vary, not only from hospital to hospital within the United Kingdom, but from east to west worldwide. While computed tomography (CT) remains the most widely used imaging technique for the preoperative staging of patients with gastric cancer, this modality is limited in its ability to detect local invasion and lymph node metastases [5][6][7][8]. Moreover, we have already shown that specialized radiological support improves the perceived preoperative stage of gastric cancer and reduces the rate of open-and-shut laparotomy [9].Although routine laparoscopy is now advocated in the preoperative staging of gastric cancer [4], there are discrepant results in the literature as to the clinical value of this procedure [10]. The aims of this study therefore, were to compare the perceived preoperative stage of gastric cancer as determined by CT and laparoscopy, and to compare this perceived stage with the final true histopathological stage. It was our hypothesis that laparoscopy would improve the accuracy of our preoperative staging process. Patients and methods Between

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Chemotherapy for advanced gastric cancer

Wagner

Grothe

Behl

et al. 2005

Cochrane Database of Systematic Reviews

149

151

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Chemotherapy significantly improves survival in comparison to best supportive care. In addition, combination chemotherapy improves survival compared to single-agent 5-FU, but the effect size is much smaller. Among the combination chemotherapy regimens studied, best survival results are achieved with regimens containing 5-FU, anthracyclines and cisplatin. In this category, ECF (epirubicin, cisplatin and continuous infusion 5-FU) is tolerated best.

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One-year survey of carcinoma of the oesophagus and stomach in Wales

Abstract: Tumour resection conferred a survival advantage. Wider use of laparoscopy is advocated. Improved selection for surgery should result in a lower mortality rate.

Cited by 62 publications

References 34 publications

Definitive chemoradiation in patients with inoperable oesophageal carcinoma

Definitive chemoradiation in patients with inoperable oesophageal carcinoma

Laparoscopy significantly improves the perceived preoperative stage of gastric cancer

Chemotherapy for advanced gastric cancer

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