Surgery for oesophagogastric cancer is a double-edged sword

Prof Wendy Brown (centre) and Dr Paul Burton (to Wendy's left) are co-authors on a paper investigating how surgery, while effective for removing tumours, can spread cancer cells.

by Anne Crawford

Radical surgery is the principal treatment to cure oesophagogastric cancer, one of the most rapidly increasing and deadliest cancers. But it has long been suspected that in some cases the surgical incisions involved can cause unseen microscopic deposits of cancer to disseminate and spread throughout the body.

Researchers in The Alfred’s Hospital’s Upper Gastrointestinal (GI) Surgical Unit investigated what was behind the surgery-induced spread in the cancer with findings that have important implications for further research aimed at identifying potential therapeutic solutions. Two more studies are currently underway.

Study highlights best use of innovative gastrointestinal device

Dr Geraldine Ooi, first author on
the EndoVAC study

by Anne Crawford

Gastric and oesophageal perforations and leaks can be very difficult to treat, particularly if   contamination and sepsis have set in, and can be fatal. Central Clinical School PhD student Dr Geraldine Ooi joined researchers in The Alfred Hospital’s Upper Gastrointestinal Surgical Unit to review a recent innovation used to treat the internal leaks. The results of their study have helped inform The Alfred Hospital’s approach to using the therapy and will potentially help clinicians elsewhere.

Media mention: "Well worth the weight" on outcomes of high volume bariatric surgery in the public system

Bariatric surgery has not been widely used in the Australian public health system. As obesity is strongly associated with socio-economic status, excluding its use from the public system will deny many of the most in-need access to a potentially very effective treatment. Alternatively, with rigorous follow-up and behavioural change requirements, highly successful outcomes in the private system may not translate to the public system. Patients were older, heavier and suffered more co-morbid disease than previously reported cohorts. This article by Monash-Alfred researchers concluded however that for the first time, excellent outcomes across a range of key quality domains in a large patient cohort have been reported in the public system. High-volume bariatric surgery in the public system is viable.

Reference: Burton P, Brown W, Chen R, Shaw K, Packiyanathan A, Bringmann I, Smith A, Nottle P. Outcomes of high-volume bariatric surgery in the public system. NZ J Surg. 2015 Oct 16. doi: 10.1111/ans.13320. [Epub ahead of print]