P-OGC09 Evaluating the Availability of Services for Cancer Patients Following Surgical Resection of Esophago-Gastric Tumours

Abstract Background Upper gastrointestinal (UGI) cancers account for 11% of cancers in the UK, with oesophago-gastric cancers having the highest incidence rate in males. Since publication of the NHS Cancer Plan in 2001, mortality rates of oesophago-gastric cancer patients following curative surgery have been decreasing, causing an increased demand for services, particularly during follow-up post-operatively. Current guidelines recommend that patients are treated by specialised multi-disciplinary teams, involving both cancer nurse specialists and dieticians. However, the integration of these workers into patient care is still ongoing in UGI, with no national recommendations for trusts on the minimum requirements needed to run adequate services. Methods This was a retrospective observational study from October 2020 to April 2021. Cancer nurse specialists from all cancer trusts in England and Wales carrying out surgical resection of oesophago-gastric tumours were identified and contacted to complete a survey. The survey was divided into 4 main themes: the organisational setup of the trust, the follow-up of patients, the dietetic input and post-operative symptoms and survivorship. Results A total of 12 trusts out of 38 returned a completed survey. Differences were observed in the number of CNSs and UGI dieticians available across trusts. 50% of responders felt that the number of CNSs at their trust was not adequate to run efficient services for patients. In 42% of cases, the CNS was solely responsible for long-term follow-up of patients, up to 5-years in the majority of trusts. 11 trusts routinely follow-up patients with a dietician, integrated into MDT clinics. 75% of trusts had an associated patient group that could provide additional support to patients. Conclusions Differences in the availabilities of services and staff for oesophago-gastric cancer patients are present across trusts in England, which can lead to inequalities in patient care. Further longitudinal studies are needed to evaluate the impact of these differences on patient surgical outcomes and mortality.

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The impact of the extent of surgical resection on survival of gastric cancer patients

OncoTargets and Therapy ◽

10.2147/ott.s97699 ◽

2016 ◽

Vol Volume 9 ◽

pp. 4687-4694 ◽

Cited By ~ 1

Author(s):

Manol Sokolov ◽

Mariela Vasileva ◽

Konstantin Grozdev ◽

Svetoslav Toshev ◽

Kostadin Angelov ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Surgical Resection ◽

Gastric Cancer Patients ◽

The Impact ◽

Extent Of Surgical Resection

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Prevalence and Clinical Implications of Ascites in Gastric Cancer Patients after Curative Surgery

Journal of Clinical Medicine ◽

10.3390/jcm10163557 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3557

Author(s):

Ju-Hee Lee ◽

Sung-Joon Kwon ◽

Mimi Kim ◽

Bo-Kyeong Kang

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Curative Resection ◽

Small Volume ◽

Pelvic Cavity ◽

Clinical Implications ◽

Curative Surgery ◽

Curative Gastrectomy ◽

Gastric Cancer Patients

We aimed to determine the frequency and clinical significance of ascites that developed during the follow-up period in patients who underwent curative resection for gastric cancer. The study included 577 patients with gastric cancer who underwent curative gastrectomy. Among them, 184 showed ascites in postoperative follow-up images. Benign ascites was observed in 131 of 490 patients without recurrence, 48 patients (of 87) with recurrence had malignancy-related ascites, and the remaining 5 patients had ascites only prior to recurrence. In most patients without recurrence (97.7%) and in 50% of patients with malignancy-related ascites, the ascites was small in volume and located in the pelvic cavity at the time that it was first identified. However, with the exception of nine patients, malignancy-related pelvic ascites occurred simultaneously or after obvious recurrence. Of those nine patients who had minimal pelvic ascites before obvious recurrence, only one had a clear association with a malignancy-related ascites. In the multivariate analysis, an age of ≤45 was the only independent risk factor for the occurrence of benign ascites. A small volume of pelvic ascites fluid is common in young gastric cancer patients who do not have recurrence after gastrectomy, regardless of sex. It is rare for ascites to be the first manifestation of recurrence.

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Impact of Palliative Gastrectomy in Patients with Incurable Gastric Cancer

Medicina ◽

10.3390/medicina57030198 ◽

2021 ◽

Vol 57 (3) ◽

pp. 198

Author(s):

Ji Yeon Park ◽

Byunghyuk Yu ◽

Ki Bum Park ◽

Oh Kyoung Kwon ◽

Seung Soo Lee ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Tumor Resection ◽

Palliative Resection ◽

Primary Tumors ◽

Palliative Intent ◽

Palliative Gastrectomy ◽

Gastric Cancer Patients ◽

The Impact

Background and Objectives: The prognosis of metastatic or unresectable gastric cancer is dismal, and the benefits of the palliative resection of primary tumors with noncurative intent remain controversial. This study aimed to evaluate the impact of palliative gastrectomy (PG) on overall survival in gastric cancer patients. Materials and Methods: One hundred forty-eight gastric cancer patients who underwent PG or a nonresection (NR) procedure between January 2011 and 2017 were retrospectively reviewed to select and analyze clinicopathological factors that affected prognosis. Results: Fifty-five patients underwent primary tumor resection with palliative intent, and 93 underwent NR procedures owing to the presence of metastatic or unresectable disease. The PG group was younger and more female dominant. In the PG group, R1 and R2 resection were performed in two patients (3.6%) and 53 patients (96.4%), respectively. The PG group had a significantly longer median overall survival than the NR group (28.4 vs. 7.7 months, p < 0.001). Multivariate analyses revealed that the overall survival was significantly better after palliative resection (hazard ratio (HR), 0.169; 95% confidence interval (CI), 0.088–0.324; p < 0.001) in patients with American Society of Anesthesiologists Physical Status (ASA) scores ≤1 (HR, 0.506; 95% CI, 0.291–0.878; p = 0.015) and those who received postoperative chemotherapy (HR, 0.487; 95% CI, 0.296–0.799; p = 0.004). Among the patients undergoing palliative resection, the presence of <15 positive lymph nodes was the only significant predictor of better overall survival (HR, 0.329; 95% CI, 0.121–0.895; p = 0.030). Conclusions: PG might lead to the prolonged survival of certain patients with incurable gastric cancer, particularly those with less-extensive lymph-node metastasis.

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Clinical and Oncological Value of Preoperative BMI in Gastric Cancer Patients: A Single Center Experience

Gastroenterology Research and Practice ◽

10.1155/2015/810134 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Costantino Voglino ◽

Giulio Di Mare ◽

Francesco Ferrara ◽

Lorenzo De Franco ◽

Franco Roviello ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Blood Proteins ◽

Term Survival ◽

Long Term Survival ◽

Single Center Experience ◽

Group B ◽

Gastric Cancer Patients ◽

The Impact

Introduction. The impact of preoperative BMI on surgical outcomes and long-term survival of gastric cancer patients was investigated in various reports with contrasting results.Materials & Methods. A total of 378 patients who underwent a surgical resection for primary gastric cancer between 1994 and 2011 were retrospectively studied. Patients were stratified according to BMI into a normal group (<25, group A), an overweight group (25–30, group B), and an obesity group (≥30, group C). These 3 groups were compared according to clinical-pathological characteristics, surgical treatment, and long-term survival.Results. No significant correlations between BMI and TNM (2010), UICC stage (2010), Lauren’s histological type, surgical results, lymph node dissection, and postoperative morbidity and mortality were observed. Factors related to higher BMI were male genderP<0.05, diabetesP<0.001, and serum blood proteinsP<0.01. A trend to fewer lymph nodes retrieved during gastrectomy with lymphadenectomy in overweight patients (B and C groups) was observed, although not statistically significant. There was no difference in overall survival or disease-specific survival between the three groups.Conclusion. According to our data, BMI should not be considered a significant predictor of postoperative complications or long-term result in gastric cancer patients.

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