Imperial College Healthcare NHS Trust

Management of High Grade Dysplasia patients

Time period: 2018-22
Cancer Alliance National
Number of High Grade Dysplasia patients in audit 48 1120
Cancer Alliance National
Method of Diagnosis
– First diagnosis confirmed by second pathologist N/A 95.5% 90.0%
Treatment planning
– HGD plan discussed at MDT N/A 95.8% 93.0%
– Treatment plan for active treatment N/A 85.0% 82.0%
First treatment
– Endoscopic therapy (such as endoscopic resection) N/A 85.0% 78.0%
– Surveillance N/A 2.5% 11.0%

NOTE: Percentages have been calculated based on the number of patients with recorded data for each variable and not the total number of patients in the Cancer Alliance.

Management of oesophago-gastric cancer patients

Time period: 2020-2022
Organisation National
Number of oesophago-gastric (OG) cancer patients in audit 131 19,865
Case ascertainment for OG cancer (%) 75-84%
Method of Diagnosis
– Patients diagnosed after an emergency admission**
** Percent figure accounts for differences in mix of patients across organisations
12 8.9% 13.1%
– Patients with referral source reported as unknown 4 3.1% 1.4%
Pre-treatment staging of cancer
– Patients having staging CT scan recorded 72 55.0% 94.0%
Treatment planning
– Patients having a plan for curative treatment 74 56.5% 37.2%
– Patients having a plan for non-curative treatment 57 43.5% 62.8%
– Patients with non-curative plans having chemotherapy or radiotherapy 29 50.9% 34.7%

Outcomes for OG cancer patients who have curative surgery

Time period: 2019-2022
Organisation National
Number of patients having surgery 186 5452
Length of stay, median (days) 13 10
Operations in which 15 or more lymph nodes were examined (%) 97.2% 90.1%
30-day postoperative mortality (%) 0.0% 1.5%
90-day postoperative mortality (%) 3.4% 2.9%
Oesophageal surgery
Number of patients having oesophageal surgery 104 N/A
Oesophageal patients with positive longitudinal margins (%) 5.4% 4.9%
Oesophageal patients with positive circumferential margins (%) 10.4% 21.5%
Gastric surgery
Number of patients having gastric surgery 82 N/A
Gastric patients with positive longitudinal margins (%) 6.9% 9.8%

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