IMPACT organizational survey highlighting provision of services for patients with locally advanced and recurrent colorectal cancer across Great Britain and Ireland

Deena Harji; Abigail Vallance; Temi Ibitoye; Richard Wilkin; Jemma Boyle; Rachael Clifford; Liam Convie; Michael Duff; Ken Elavia; Martyn Evans; Christina Fleming; Ben Griffiths; John T Jenkins; Helen Mohan; E J Morris; Clare Taylor; Gabrielle Thorpe; Jim Tiernan; Nicola Fearnhead; ACPGBI IMPACT

doi:10.1111/codi.17139

IMPACT organizational survey highlighting provision of services for patients with locally advanced and recurrent colorectal cancer across Great Britain and Ireland

Colorectal Dis. 2024 Oct 22. doi: 10.1111/codi.17139. Online ahead of print.

Authors

Deena Harji¹, Abigail Vallance², Temi Ibitoye³, Richard Wilkin⁴, Jemma Boyle⁵, Rachael Clifford⁶, Liam Convie⁷, Michael Duff⁸, Ken Elavia⁹, Martyn Evans¹⁰, Christina Fleming¹¹, Ben Griffiths¹, John T Jenkins¹², Helen Mohan¹³, E J Morris¹⁴, Clare Taylor¹², Gabrielle Thorpe¹⁵, Jim Tiernan¹⁶, Nicola Fearnhead¹⁷; ACPGBI IMPACT¹⁸

Collaborators

ACPGBI IMPACT:
Tushar Agarwal, Kamal Aryal, Ceri Beaton, Ashish Bhalla, Graham Branagan, Keith Chapple, Hamish Clouston, Peter Coyne, Andrew Day, James Eccersley, Henry Ferguson, Mark L George, Rina George, Emma Hamilton, Ben Hornung, R B N Khan, Barrie Keeler, Thu Linn, David McArthur, Frank McDermott, Malcolm McFall, Sarah J Mills, Daniel O'Leary, Marius T Paraoan, Syed Fida Rahman-Casans, Nirooshun Rajendran, Andrew Ramwell, Shantanu Rout, Matthew D Rutter, Mohammed M Sadat, David Sallomi, Ajai Samad, Paul Skaife, Richard Slater, Mamoon Solkar, William Speake, Nicholas Symons, Karen Telford, Nicholas Ward, David Westwood, Max Wilde, Jeremy Wilson, Firas Younis

Affiliations

¹ Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
² Department of Colorectal Surgery, Bristol Royal Infirmary, Bristol, UK.
³ Population Health Science Institute, Newcastle University, Newcastle upon Tyne, UK.
⁴ Department of Surgery, NHS Trust, Worcestershire Acute Hospitals, Worcester, UK.
⁵ Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK.
⁶ Department of Colorectal Surgery, Countess of Chester National Health Service Foundation Trust, Chester, UK.
⁷ Belfast Health and Social Care Trust, Belfast, UK.
⁸ Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
⁹ IMPACT PPI Group, Association of Coloproctologists of Great Britain and Ireland, London, UK.
¹⁰ Department of Colorectal Surgery, Singleton Hospital, Swansea, UK.
¹¹ Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland.
¹² Complex Cancer Clinic, St Mark's Hospital, Harrow, UK.
¹³ Peter MacCallum Cancer Center, Melbourne, Australia.
¹⁴ Big Data Institute, Oxford Population Health, University of Oxford, Oxford, UK.
¹⁵ School of Health Sciences, University of East Anglia, Norwich, UK.
¹⁶ The John Goligher Colorectal Surgery Unit, St. James's University Hospital, Leeds Teaching Hospital Trust, Leeds, UK.
¹⁷ Department of Colorectal Surgery, Cambridge University Hospitals, Cambridge, UK.
¹⁸ Improving Outcomes for Advanced Colorectal Tumours, Association of Coloproctologists of Great Britain and Ireland, London, UK.

PMID: 39435558
DOI: 10.1111/codi.17139

Abstract

Aim: Locally advanced and recurrent colorectal cancer represents a complex clinical entity, which requires multidisciplinary decision-making and management. The aim of this work is to understand the provision of clinical services in this cohort of patients across Great Britain and Ireland (GB&I) as a key essential step to help facilitate future service development and improvement.

Method: A cross-sectional, organizational survey was sent to all colorectal cancer multidisciplinary teams (MDTs) across GB&I. It consisted of 12 key questions addressing the provision of specialist services and advanced surgical techniques. Results are reported in line with the CHERRIES guideline.

Results: One hundred and seventy-five MDTs across GB&I participated, with 142 English, 13 Welsh, 14 Scottish, 3 Northern Irish and 3 Irish MDTs. The overall response rate was 93.5% (175/187). Ninety (51.4%) hospital sites reported having a specialist dedicated or subsection MDT. Specialist advanced nursing support was available in 46 (26.2%) hospitals, with a dedicated advanced colorectal cancer outpatient clinic available in 31 (17.7%) hospitals. One hundred and thirteen MDTs (64.5%) offered surgery for advanced colonic cancer, 82 (46.8%) for recurrent colonic cancer, 58 (33.1%) for advanced rectal cancer and 39 (22.2%) for recurrent rectal cancer. A variable number of MDTs offered specialist surgical techniques, including distal sacrectomy [33 (18.9%)], high sacrectomy [16 (9.1%)], complex vascular resection ± reconstruction [33 (18.9%)] and extended lymphadenectomy (pelvic sidewall or para-aortic) [44 (25.1%)].

Conclusion: The IMPACT organizational survey highlights the current variation in the delivery and provision of clinical services for patients with advanced and recurrent colorectal cancer across Great Britain and Ireland.

Keywords: advanced rectal cancer; pelvic exenteration; rectal cancer; recurrent rectal cancer.

Grants and funding

Bowel Research UK