1. Northern Oesophago Gastric Cancer Unit MDT data NECN Audit Meeting – 6 th November 2013

2. Methods Patients discussed at weekly Newcastle Multi-disciplinary Team meeting in period January – December 2012 Excludes patients discussed by video-link to Sunderland Prospective data entry onto database - Dendrite Intended use: Local, Regional & National audit Research Data then exported onto Microsoft Excel for analysis

3. National Audit Programme The second Audit began collecting prospective data on patients (aged 18 years or over) diagnosed with invasive epithelial cancer of the oesophagus, gastro- oesophageal junction (GOJ) or stomach on or after 1 April 2011. Since 1 April 2012, the Audit has also included patients diagnosed with oesophageal high-grade glandular dysplasia (HGD). To allow this, a slightly revised dataset was implemented in April 2012.

4. National Audit 2013 – Resections by site

5. MDT Discussions n=1511 incl Carlisle 588 excl Carlisle

6. New discussions N = 674 538 + cancers Other incl. – GISTs, HGD, LGD, Surveillance pts, & referred onto another MDT

7. New OG neoplasm n=463

8. Number of MDT Discussions N=588 – New Discussions Excl. 86 Carlisle pts Median discussion: 2

9. Age

10. Carlisle Discussions

11. New referrals to MDT by site n=450 vs. 324 vs. 408 vs 467 vs 437 vs 463 excl Carlisle pts – positive cancers only

12. Intention to treat by site - 2012 No action – incl. Benign, Best supportive care & referral onto other MDT’s Friday MDT’s only

13. Oesophageal Cancer: (2012) Histological subtype Other incl. – Carcinoid, Leioyoma, melanoma, benign

14. Oesophageal Cancer: Treatment intent by histological subtype

15. Oesophageal cancer: Curative treatment intent

16. Actual Resections - Pos Cancers only

17. Procedures 2012 CompletedIncompl.30 day90 dayComps 3+ Accordion Oesophagectomy8340325 Total Gastrectomy353135 Subtotal Gastrectomy 502007 Lesser resection130002 EMR35N/A000

18. Morbidity/Complications note: 30 day Mort all complications incl. n=137 - 2009 n=149 - 2010 n=162 - 2011 N=168 - 2012

19. Pathological Stage by subtype Excl. Carcinoid’s & Leioyoma’s excluded, 8 open and close excluded

20. Oesophageal Cancer: Treatment change Intended TreatmentTreatment Changen Neoadjuvant + SurgeryUnfit for surgery3 Neoadjuvant + SurgeryProgression of disease, no surgery7 Neoadjuvant + SurgeryRIP (1 cycle)2 Neoadjuvant + SurgeryPatient declined2 SurgeryNot fit for surgery/patient declined2 Neoadjuvant + SurgeryShortened chemotherapy due to toxicity5 Neoadjuvant + SurgeryNo neoadjuvant given2 ChemoradiotherapyToxicity 1 pt did not complete chemo, although did complete radio. 1

21. Recruitment to trials - 2012 Please note: Cougar 02 closed 30/04/12. Other trials had closed

22. UGI Two Week Waits 2012 62 day breaches: 14.5 (0.84%)

23. Refs- 2 Week Waits – Comparison by Year

24. Breaches - Comparison

25. Acknowledgements Helen JaretzkeNOGCU Data Manager Angie TateNOGCU Data Clerk Paula BrooksMDT Coordinator Jonathan StoddartNCCC Research Coordinator