1. NSSG OG AUDIT DAY 2013 South Tees Hospitals Foundation Trust Sam Dresner, Consultant Surgeon Helen Wescott, OG Cancer CNS

2. MDT Workload New patients discussed Jan – Dec 2012 -575 New patients discussed Jan - Dec 2011 -474

3. Upper GI New Patients OG20112012 Oesophagus144177 OG914 Stomach9384 GIST1013 Total256287

4. HPB New Cases HPB20112012 Pancreas6285 Bile duct3234 Liver1422 Small bowel27 Ampulla14 Total111152

5. New cases - other Other20112012 Unknown2213 Not UGI Cancer2438 Not Cancer5284 Total98135

6. Number of MDT discussions

7. Patients By Referral Unit

8. Histological Subtype (oesophagus, juctional, stomach) Oesophagus Cell Type 20112012 Adenocarcinoma181199 Carcinoma212 HGD48 Squamous cell carcinoma 4338 Small Cell11 Not known1110 NET27

9. Treatment Modality Tumour TypeCurative / Radical Treatment 2011 2012 Non Curative 2011 2012 OesophagusSurgery Neoadjuvant Chemo/rad Radical Rad 2 nd opinion EMR RFA 10 28 13 1 6 40 17 2 5 3 1 BSC Stent Brachytherapy APC Pall chemo Pall Radio 52 1 26 13 48 2 1 35 15 Total 2012 177 52 74 92103 StomachSurgery Neoadjuvant EMR 2 nd opinion Other 21 9 1 16 15 2 1 2 BSC Pall chemo Pall Radio Surgery(bypass) 48 13 3 1 33 9 4 1 Total 2012 83 32366247 GOJNeoadjuvant Chemo/rad 34141 BSC Pall chemo Pall Radio 231231 4545 Total 2012 14 3 56 9 Small BowelSurgery HPB 2 1 Pall chemo BSC 2 4 Total 2012 7 324 GISTSurgery EMR 48W&W Glivec RT BSC 231231 321321 Total 14 4 866

10. OG Resection Audit Elective / emergency OG database JCUH 2011 - 104 patients 2012 - 96 patients M:F 65:31

11. Procedures 96 patients EMR n=5 Palliative bypass local hospital – metastatic gastric cancer (DMH) n=1 – metastatic pancreatic cancer (FHN) n=1 Emergency (perforation/obstruction) – palliative resection n=1 Small bowel resections n=2 86 elective OG cancer resections – 95 OG cancer resections 2011

12. Procedures ProcedureSMDPADYKSV Open subtotal gastrectomy Laparoscopic subtotal gastrectomy Laparoscopic assisted subtotal gastrectomy Open total gastrectomy Open total gastrectomy + splenectomy Extended total gastrectomy Laparoscopic / VATS oesophagectomy Laparoscopic / VATS oesophagectomy + lung resection Open oesophagectomy Open oesophagectomy and splenectomy Open oesophagectomy + colonic resection Inoperable Total 2 9 0 4 1 2 0 7 0 2 0 29 5 0 6 0 16 0 4 31 3 0 5 4 0 6 1 4 26

13. Outcomes Inoperability (8/86) 9.3% Re-operation (3/86)3.5% – Bleeding n=2, Perforation n=1 Leak rate (Oesophagectomy 3/37)8.1% 30-day mortality0% 90-day mortality0% In-hospital mortality0% LOS (1-74)Median 11 days