title: Improved survival in resected oesophageal and gastric adenocarcinomas over a decade: the Royal Marsden experience 2001-2010.
abstract: BACKGROUND
  Oesophageal and gastric adenocarcinoma (OGA) treatment remains challenging. Improvements in early diagnosis, staging and management might have contributed to survival prolongation. To examine this hypothesis, we assessed outcomes of resected OGA patients in our institution over 10 years, comparing two time periods, 2001-2005 and 2006-2010.
  
  
  METHODS
  Records from patients who had undergone surgery with radical intent and follow-up for OGA were retrospectively reviewed. Patients followed up at hospitals other than the Royal Marsden Hospital were excluded. Two different cohorts were identified: patients with oesophageal and type I or type II oesophagogastric junction (OGJ) tumours, and patients with gastric and type III OGJ tumours.
  
  
  RESULTS
  We identified 360 patients: 147 from 2001-2005 and 213 from 2006-2010. The characteristics were comparable across the two time periods. Between 2001-2005 and 2006-2010, the percentage of R0 resections increased (from 67.1 to 81.1 % for proximal tumours and from 76.3 to 95.9 % for gastric and type III OGJ tumours). The mean number of lymph nodes retrieved increased over time. The 5-year overall survival rate increased significantly from 42.3 to 56.6 % for proximal tumours and from 38.8 to 55.3 % for gastric and type III OGJ tumours. Similarly, the disease-free survival rate significantly increased from 34.6 to 53.5 % for proximal tumours and from 35.9 to 51.1 % for gastric and type III OGJ tumours.
  
  
  CONCLUSIONS
  This study comprehensively describes the improvement in survival outcomes in a major UK referral centre over a 10-year period, identifying potentially relevant factors such as increased number of R0 resections and higher lymph node yield.
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Elisa
authors.initials: E
authors.lastname: Fontana
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Smyth
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: David
authors.initials: D
authors.lastname: Cunningham
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Sheela
authors.initials: S
authors.lastname: Rao
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: David
authors.initials: D
authors.lastname: Watkins
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: William H
authors.initials: WH
authors.lastname: Allum
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Thompson
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Waddell
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Peckitt
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Chau
authors.affiliation: Royal Marsden Hospital, Downs Road, Sutton, SM2 5PT, UK. naureen.starling@rmh.nhs.uk.
authors.forename: Naureen
authors.initials: N
authors.lastname: Starling
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult
keywords: Clinical management; Gastric adenocarcinoma; Oesophageal adenocarcinoma; Oesophagogastric junction adenocarcinoma; Surgical resection