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Clinical T1 Cancers

Clinical T1 Cancers. S Wahed OG NSSG Audit Day 6 November 2013. RVI. N = 30; resections only. RVI - Oesophagus. N = 12 11 lower third, 2 middle third Median age 63 range 41 – 76 M:F 8:4 All EUS CT-PET 1 Bone scan 1. EMR  surgery 5 Surgery 7 Neoadj 1 (cT1 N1) All pT1 N0.

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Clinical T1 Cancers

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  1. Clinical T1 Cancers S Wahed OG NSSG Audit Day 6 November 2013

  2. RVI • N = 30; resections only

  3. RVI - Oesophagus • N = 12 • 11 lower third, • 2 middle third • Median age 63 • range 41 – 76 • M:F 8:4 • All EUS • CT-PET 1 • Bone scan 1 • EMR surgery 5 • Surgery 7 • Neoadj 1 (cT1 N1) • All pT1 N0

  4. RVI - Gastric • N =18 • Median age 71.5 • range 41-81 • 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

  5. RVI - Gastric • EMR 1 • Neoadj 3 (node positive) • TG 7 • STG 9 • Merindino 2

  6. RVI – Gastric Resections • 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

  7. JCUH • N = 20; includes non-resections • May 2012 – April 2013

  8. JCUH - Oesophageal • N = 17 • Median age 70 • range 52-98 • M:F 11:6 • EUS 2 • Surgery 4 • EMR 4 • +1 surgery • +1 CRT • Chemorad 5 • SCC 3, AC 1, HGD 1 (?) • Pall DXT 1 SCC • BSC 2 • Refer 1

  9. JCUH - Oesophageal • Resections • 3 pT1 N0 AC • 1 HGD • EMR • 3 HGD • 1 T1 N0 AC

  10. JCUH - Gastric • N = 3 • Median age 70 • range 60-80 • M:F 2:1 • Gastric • Surgery 2 • 1 lap, 1 open • Polypectomy 1

  11. JCUH - Gastric • Resections • pT1b N0 • HGD • Polypectomy • AC

  12. 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

  13. Acknowledgements • Helen Jaretzke & Angela Tate • Helen Wescott

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