Audit of Pre-assessment Care of Patients Undergoing Chemotherapy And Surgery for Early Stage Oesophageal and Gastro-Oesophageal Junction Adenocarcinoma

Authors

Douglas R, Singh U, Sutton E, Williams A, McGaughey S, Kennedy R, Turkington R.C

Departments / Institutions

Centre for Cancer Research and Cell Biology, Queens University Belfast, Northern Ireland. Department of Surgery, Belfast City Hospital, Northern Ireland.

Publication Date

Autumn 2018

Introduction

Patients with early stage oesophageal (OAC) and gastro-oesophageal junction (GOJ) adenocarcinoma are offered platinum-based chemotherapy prior to radical surgery. Comprehensive physical and nutritional assessment is required to enable accurate patient selection

Aims

An audit of pre-assessment care of patients with early stage OAC and GOJ in the Northern Ireland Cancer Centre was undertaken to ensure that the care given to these patients is following current Association of Upper Gastrointestinal Surgeons (AUGIS) guidelines.

Methods

Clinical notes were reviewed for patients diagnosed from the
opening of the Upper GI Surgery unit in June 2015 until December
2017. Demographic, haematological, radiological, physiotherapy
and dietetic factors were collected.

Results

94 patients were diagnosed between June 2015 and 2017 of whom 74 (79%) were male and the median age was 63.5 (31-82). All patients received staging CT and CT PET scans. Fifty eight patients (62%) had endoscopic ultrasound performed. All patients were seen by a physiotherapist and dietitian at pre-assessment. Physiotherapy assessments were available for 67 (71%) patients and all patients had shuttle walk test, BORG score, heart rate and oxygen saturations recorded. Dietetics assessments were available for 64 (68%) patients and all had dysphagia scores, hand grip strength, height and weight recorded. Fifty five (86%) of patients had weight change over time period recorded.

Conclusion

Appropriate pre-assessment care was given as per current guidelines for patients with early stage oesophageal cancer.