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Carcinoma of the oesophagus and stomach in Wales: a 1‐year survey. BJS 1999; 86: 422-422.

Published: 2nd January 2003

Authors: J. K. Pye, M. K. H. Crumplin, M. E. Foster, A. Biffin, J. Charles

Background

The management and outcome of patients presenting with oesophagogastric carcinoma over a 12‐month period in Wales were reviewed.

Method

Data were collected from September 1995 to September 1996 on 916 consecutive patients and submitted to confidential data analysis. The data originated from 20 hospitals and 70 surgeons treating these patients.

Results

The number of cases managed by each hospital varied between two and 124, and by each surgeon from one to 44. Three tumour sites were identified: carcinoma of the oesophagus (n = 339), carcinoma of the cardia (gastro‐oesophageal junction; n = 193) and gastric carcinoma (n = 384). The 30‐day mortality rate was 13 per cent for oesophageal carcinoma, 12 per cent for cardia carcinoma and 11 per cent for gastric carcinoma. Resection rates for the three tumour sites were 28, 44 and 56 per cent. There were 16 anastomotic leaks overall. For patients undergoing surgery, there was an inverse relationship between case load and mortality rate. This difference narrowed when ten or more patients were operated on per annum. For surgeons consulting with more than ten patients per annum and who operated on more than 70 per cent of these, the mortality rate was 18 per cent, compared with 5 per cent for those who operated on less than 70 per cent.

Conclusion

Numerically there is a broad range of experience amongst the surgeons who treat carcinoma of the oesophagus and stomach in Wales. There may be an optimum minimal case load and, with careful selection of␣patients for surgery, morbidity and mortality rates should be minimized. © 1999 British Journal of Surgery Society Ltd

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