M.Boal; J. Batt; P. Wilkerson; D.R. Titcomb

Slides:



Advertisements
Similar presentations
Implementing NICE guidance
Advertisements

North Tees University Hospital Audit of T1 Rectal Cancers September 2013 – August 2014 Nicola Maguire Teaching fellow General Surgery 12/09/2014.
Luigi Bonavina,MD Cattedra e U.O. Chirurgia Generale, Policlinico San Donato Università degli Studi di Milano XXIV Congresso Nazionale A.C.O.I. Montecatini.
National Oesophago–Gastric Cancer Audit Comparing local and national figures.
Endoscopy – Should Everyone Be Tested? Primary Care Management of Dyspepsia Symposium Roland Valori Consultant Gastroenterologist Gloucestershire Royal.
Endoscopic Treatment of Barrett’s Esophagus and Early Esophageal Cancer CTOP Retreat 2014 Dartmouth-Hitchcock Medical Center.
Senior Lecturer in Gastroenterology Consultant Gastroenterologist
Management of Barrett’s oEsophagus
Upper GI Disease Where we are Dr Gary Mackenzie Consultant Gastroenterologist.
Colonoscopic surveillance for prevention of colorectal cancer in people with ulcerative colitis, Crohn’s disease or adenomas NICE CG March 2011.
Should colonoscopy be performed one year out from colorectal cancer resection? Alexandra Kent, Philip Thompson, Prof Alan Horgan, Mr Paul Hainsworth Newcastle.
National Oesophago–Gastric Cancer Audit Key Findings from 2014 Annual Report and Progress Report Georgina Chadwick Clinical Research Fellow.
Dr Poonam Valand, Foundation Year Two Dr Anjan Dhar, Consultant Gastroenterologist COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST Early gastric cancer.
Best Treatment for Barrett’s is Surgery
Gastroenterology Grand Rounds February 20, 2014 Fellow: David Tang, M.D. Faculty: Marcelo Vela, M.D.
Management of Pancreatitis at NMUH Chris Bretherton Surgical FY1 Audited against UK guidelines for the management of acute pancreatitis from British Society.
Radiofrequency Ablation for Barrett’s Esophagus with HGD Gregory G. Ginsberg, M.D. Professor of Medicine University of Pennsylvania School of Medicine.
MORTALITY AUDIT Dr S Callin SpR Palliative Medicine Dr L Russon Consultant Palliative Medicine BRI Palliative Care Team.
Liam Murray Cancer Epidemiology and Prevention Research Group Queen’s University Belfast Dublin September 3 rd 2009 The Northern Ireland Barrett’s Register:
Stereotactic Ablative Body Radiotherapy for Non small cell lung cancer
National Oesophago–Gastric Cancer Audit  This slide set is designed to ◦Summarise the main audit findings for presentation at local MDT meetings.
The management of low-risk basal cell carcinomas in the community Implementing NICE guidance in general practice May 2010 NICE guidance on cancer services.
Prostatectomy operations in England South West Public Health Observatory Trends in the use of radical prostatectomy in England Sean McPhail.
Cervical Cancer: Experiences from a Cohort of HIV-infected Women Pascoe M, Magure T, Mudhokwani P et al Abstract: MOAB0202.
REGIONAL GASTROSTOMY AUDIT FOR HEAD AND NECK CANCER D Bailey 1 D Baldwin 2, S Caldera 3 Cancer Intelligence Service, South.
Minesh Mehta, PGY-4 University of Louisville Department of Gastroenterology BARRETT’S ESOPHAGUS.
TACE for HCC in a regional centre: 5 year audit and assessment of baseline predictors of outcome Iain DS Morrison, #R Kasthuri, EH Forrest, S Barclay,
Dept. Paediatrics, Leicester Royal Infirmary, Leicester
Oesophago–Gastric Cancer Audit
Brain imaging prior to lung cancer resection
Fracture Liaison Service Database
Volume 145, Issue 1, Pages (July 2013)
Upper Gastrointestinal Cancers Top ⑩ Tips
Rapid on-site evaluation may optimize patient selection for radio-frequency-ablation therapy Dr Wolfgang Pokieser Pathologisch-bakteriologisches Institut.
Oesophago–Gastric Cancer
THE USE OF A WRITTEN ASTHMA ACTION PLAN IN PATIENTS DISCHARGED FROM THE EMERGENCY DEPARTMENT OF THE MATER MISERICORDIAE UNIVERSITY HOSPITAL Dr. Nafisah.
Authors: Puccio I. 1; Butt MA1, 2; Oukrif D4; Khan S 1; Haidry RJ
National Oesophago–Gastric Cancer Audit 2015.
1 Maidstone and Tunbridge Wells NHS Trust (Kent Oncology Centre)
A prospective study of endoscopic radiofrequency application (STRETTA) for gastroesophageal reflux disease: Early UK experience N Hamza, D Kamali, S Punnoose,
Long-term impact of response to interferon-based therapy in patients with chronic HCV in relation to liver function, survival and cause of death Philip.
Compassionate People World Class Care
Outcomes of patients in the North Trent region with advanced non-small-cell lung cancer treated with maintenance pemetrexed following induction with platinum.
The effect of neo-adjuvant chemotherapy on the discrepancy between the endoscopic ultrasonography (EUS) and pathological staging of oesophageal cancer.
Treatment With Continuous, Hyperfractionated, Accelerated Radiotherapy (CHART) For Non-Small Cell Lung Cancer (NSCLC): The Weston Park Hospital Experience.
Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma
Fig. 1 Flow diagram of patient selection and study design.
Oesophago–Gastric Cancer
“How to approach a patient with irregular mucosa after RFA treatment?”
Oesophago–Gastric Cancer Audit
Bristol Royal Infirmary M.Boal, D. Titcomb 2/2/17
British Association of Dermatologists National Clinical Audit Programme 2015: Atopic eczema in children (NICE CG57)
Bleeding and cancer risk in patients with vascular disease COMPASS Steering Committee and Investigators.
Oesophago–Gastric Cancer
Persistence of Human Papillomavirus, Overexpression of p53, and Outcomes of Patients After Endoscopic Ablation of Barrett's Esophagus  Shanmugarajah Rajendra,
Epidemiology, Diagnosis, and Management of Esophageal Adenocarcinoma
Barrett's esophagus: diagnosis and management
An Audit on Complex hyperplasia reporting at Derriford Hospital
Endoscopic resection and ablation versus esophagectomy for high-grade dysplasia and intramucosal adenocarcinoma  Jörg Zehetner, MD, Steven R. DeMeester,
National Oesophago-Gastric Cancer Audit 2018 Annual Report: Slide set
Barrett's esophagus: diagnosis and management
A Multicenter Retrospective Audit of Native Vertebral Osteomyelitis Cases June March 2018.
Volume 145, Issue 1, Pages (July 2013)
Nat. Rev. Gastroenterol. Hepatol. doi: /nrgastro
National Oesophago-Gastric Cancer Audit
Cox regression analysis of the proportion of patients remaining in remission during azathioprine treatment related to diagnosis of inflammatory bowel disease.
Correlation between age-standardised colorectal cancer incidence (left panel) and mortality rates (right panel) and human development index (HDI) in both.
Cox regression analysis of the proportion of patients remaining in remission after stopping azathioprine treatment related to diagnosis of inflammatory.
(A) Trends in colorectal cancer incidence and mortality in males (M) and females (F) by country (group 1: increasing or stable incidence and mortality).
 (A) Percentage of patients achieving remission or response at week 12 or 24 after initiating ova therapy.  (A) Percentage of patients achieving remission.
Presentation transcript:

M.Boal; J. Batt; P. Wilkerson; D.R. Titcomb The use of Radiofrequency Ablation (RFA) in the management of dysplastic Barrett’s oesophagus - a hospital’s experience M.Boal; J. Batt; P. Wilkerson; D.R. Titcomb U H Bristol NHS Foundation Trust Radiofrequency ablation (RFA) is a endoscopic technique used in the management of Dysplastic Barretts oesophagus (HALO therapy). It can cause compete regression or prevent disease progression which would then require radical treatment. RFA applies a bipolar current causing coagulative necrosis to oesophageal mucosa, eradicating dysplasia in 79-100% of patients and T1a early oesophageal cancers in 81-92%. Introduction Aims & Method The aim was to assess rates of oesophageal high grade dysplasia progression/regression for patients who underwent RFA at one hospital. The sample population, treated at a single cancer centre by 2 Consultant Upper Gi Surgeons, included those selected to undergo HALO therapy for oesophageal high grade dysplasia, excluding non-dysplastic and squamous dysplasia as per NICE and British Society of Gastroenterology (BSG) recommendations. Data was collected using patients’ case notes or electronic patient record between June 2011 to February 2018. Follow-up outcome data was collected after this period. MDT discussion, histology, radiology, operative notes and discharge letters were all examined. Results Conclusion A total of 85 patients were followed up, 73 were male and 12 female. Median age at index procedure was 69 (range 45-91). The data collected at this site showed that regression percentages were 82% (63/77) at the first histology after their first RFA procedure and 83% (49/59) of those who have had subsequent biopsies. Those diagnosed with adenocarcinoma had a regression percentage of 93.3% (14/15), with one patient (6.7%) progressing to more radical treatment. Four patients in total went on to have more radical treatment. This data shows that endoscopic RFA for the treatment of dysplastic Barretts Oesophagus is being appropriately offered to patients in this cancer centre with appropriate follow up. The outcomes, even with a small sample size, correlate with national data. The National Oesphago-Gastric Cancer Audit (NOGCA) stated that 29.7% of people with Tis/T1a adenocarcinoma and HGD are offered surveillance, despite the BSG recommending the use of RFA. Our data enforces the national guideline that patients in peripheral hospitals not offering RFA should be referred to specialist centres for treatment. References Endoscopic radiofrequency ablation for squamous dysplasia of the oesophagus. NICE guidance 2014. Endoscopic radiofrequency ablation for Barrett's oesophagus with low‑grade dysplasia or no dysplasia” NICE guidance 2014. Barrett's oesophagus: ablative therapy. NICE guidance 2010 Fitzgerald RC, Di Pietro M et al. Revised British Society of Gastroenterology recommendation on the diagnosis and management of Barrett's oesophagus with low-grade dysplasia” Gut BMJ 2017 Fitzgerald RC, di Pietro M, Ragunath K, et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus. Gut 2014;63:7-42. National Oesophago-Gastric Cancer Audit Annual Report 2017.