Oesophageal & gastric (stomach) cancer surgery specialist centres NSW
Criteria for oesophagogastric cancer specialist centres
An oesophagectomy is surgery to remove the oesophagus. It is complex surgery, which requires a team of health care professionals with suitable experience performing this surgery and providing supportive care after surgery.[1]
Surgery to remove the stomach is called gastrectomy. It is also a complex surgery, which is similar to an oesophagectomy.
Australian and international studies indicate that patient outcomes can be improved when surgery for cancer of the oesophagus or stomach is performed in centres that do a high number of these procedures.[2-4]
It is recommended that oesophagus and stomach cancer specialist centres perform 6 oesophagectomies per year*
* This minimum suggested annual surgical caseload has been selected based on international studies, analysis of NSW data, and the hospital-level distribution of oesophagectomies in NSW.[2-7]
It is based on the number of oesophagectomies only. Due to similarities in anatomy, surgical complexity, and supportive care required, centres will be recommended for both oesophagectomy and gastrectomy if they meet the minimum suggested annual surgical caseload for oesophagectomy.
Multidisciplinary cancer care team availability
Patients with cancer of the oesophagus or stomach may have one or more types of treatments, including surgery, endoscopic treatments, chemotherapy and radiotherapy.
The involvement of a multidisciplinary cancer care team is required.[5] This team brings together health care professionals from different specialties to discuss a patient’s cancer diagnosis and staging, and their treatment options. It also enhances communication and care co-ordination between the specialists involved in a patient’s care.[6]
International studies show that patients overseen by a multidisciplinary cancer care team experience better outcomes after cancer treatment.[5-7]
Actions for Health Professionals
Patient referral
Patients with a suspected or confirmed oesophageal or gastric cancer should be referred to a specialist who is a member of a multidisciplinary cancer care team and practices at one of the specialist centres listed below.
Even if surgery does not seem likely at the time of referral, involvement of a multidisciplinary team (MDT) early in the cancer journey is recommended to ensure optimal assessment, care, and outcomes.
The Canrefer website allows you to find cancer specialists who are MDT members, and has information about cancer services, optimal care pathways, and patient resources.
Smoking cessation support
Evidence suggests that tobacco cessation following cancer diagnosis improves survival. It also reduces treatment-related complications.[8-9] Health professionals should discuss tobacco use with all patients and provide appropriate cessation support.
List of public specialist centres for oesophageal cancer and gastric cancer surgery
| Local health district | Hospital Name | Annual average oesophagectomy caseload Jan 2021 - Dec 2022 | Multidisciplinary cancer care team |
|---|---|---|---|
| Nepean Blue Mountains | Nepean | 13-16 | Nepean Cancer Care Centre Upper Gastrointestinal Cancer MDT |
| Hunter New England | John Hunter | 13-16 | Hunter New England Urological Cancer MDT |
| South Western Sydney | Bankstown/Lidcombe | 13-16 | Bankstown Cancer Centre Upper Gastrointestinal Cancer MDT |
| Illawarra Shoalhaven | Wollongong | 6-8 | Illawarra Shoalhaven Local Health District Upper Gastrointestinal Cancer MDT |
Sydney | Royal Prince Alfred | 6-8 | Royal Prince Alfred and Lifehouse Upper Gastrointestinal Cancer MDT |
| Murrumbidgee | Wagga Wagga Base | 6-8 | Riverina Cancer Care Centre Gastrointestinal Cancer MDT |
| South Eastern Sydney | Prince of Wales | 6-8 | Prince of Wales Gastro-Oesophageal Cancer MDT |
| Central Coast | Gosford | 6-8 | Gosford Hospital Colorectal and Upper Gastrointestinal Cancer MDT |
List of private specialist centres for oesophageal cancer and gastric cancer surgery
| Local health district | Hospital Name | Annual average oesophagectomy caseload Jul 2020 - Jun 2022 | Multidisciplinary cancer care team |
|---|---|---|---|
| Northern Sydney | North Shore Private | 13-16 | Royal North Shore Hospital Pancreatic Cancer MDT |
Sydney | Chris O'Brien Lifehouse | 9-12 | Royal Prince Alfred and Lifehouse Upper Gastrointestinal Cancer MDT |
| Chris O'Brien Lifehouse | St George Private Hospital and Medical Centre | 6-8 | St George Cancer Care Centre Upper Gastrointestinal Cancer MDT |
| Northern Sydney | Sydney Adventist Private | 9-12 | Sydney Adventist Hospital Gastrointestinal Cancer MDT |
Codes
- Surgical caseload data sourced from Admitted Patient, Emergency Department Attendance, and Deaths Register (APEDDR) via Secure Analytics for Population Health Research and Intelligence (SAPHaRI), Centre for Epidemiology and Evidence, NSW Ministry of Health.
- In-scope procedures (oesophageal cancer): C15, C16.0
- In-scope procedures (oesophagectomy): 30535–00, 30536–00, 30536–01, 30541–00, 30541–01, 30545–00, 30545–01, 30550–00, 30550–01
- The data presented are for oesophagectomy only. Co-listing for gastrectomy is based on meeting the minimum suggested annual surgical caseload for oesophagectomy.
References
- Allum W, Lordick F, Alsina M, Andritsch E, Ba-Ssalamah A, Beishon M, et al. ECCO essential requirements for quality cancer care: Oesophageal and gastric cancer. Critical reviews in oncology/hematology. 2018;122:179-93.
- Iwatsuki M, Yamamoto H, Miyata H, Kakeji Y, Yoshida K, Konno H, et al. Effect of hospital and surgeon volume on postoperative outcomes after distal gastrectomy for gastric cancer based on data from 145,523 Japanese patients collected from a nationwide web-based data entry system. Gastric Cancer. 2019;22:190-201.
- van Putten M, Nelen S, Lemmens V, Stoot J, Hartgrink H, Gisbertz SS, et al. Overall survival before and after centralization of gastric cancer surgery in the Netherlands. Journal of British Surgery. 2018;105(13):1807-15.
- Varagunam M, Hardwick R, Riley S, Chadwick G, Cromwell D, Groene O. Changes in volume, clinical practice and outcome after reorganisation of oesophago-gastric cancer care in England: a longitudinal observational study. European journal of surgical oncology. 2018;44(4):524-31.
- Ju M, Wang SC, Syed S, Agrawal D, Porembka MR. Multidisciplinary teams improve gastric cancer treatment efficiency at a large safety net hospital. Annals of Surgical Oncology. 2020;27:645-50.
- Seo HS, Shin GY, Lee SH, Jung YJ, Song IH, Kim IH, et al. Clinical Implication of Multidisciplinary Team Approach for the Treatment of Gastric Cancer. Gut & Liver. 2019;13.
- Xiang Y-Y, Deng C-C, Liu H-Y, Kuo Z-C, Zhang C-H, He Y-L. The prognostic effect of multidisciplinary team intervention in patients with advanced gastric cancer. Current Oncology. 2022;29(2):1201-12.
- Jassem J. Tobacco smoking after diagnosis of cancer: clinical aspects. Translational lung cancer research. 2019;8(Suppl 1):S50.
- Warren GW, Alberg AJ, Cummings KM, Dresler C. Smoking cessation after a cancer diagnosis is associated with improved survival. Journal of Thoracic Oncology. 2020;15(5):705-8.
