HSS CPOC Service Annual Report 2021

Service Report May 2021 Colorectal and Peritoneal Oncology Centre – The Christie NHS Foundation Trust

1. Introduction The Christie Colorectal and Peritoneal Oncology Centre (CPOC) Peritoneal tumour Service (PTS) experienced a reduction in referrals with regard to the appendiceal tumour activity compared to the year 2019-2020 (259 and 278 respectively); whereas the referrals concerning patients with colorectal peritoneal metastases (CRPM) marginally increased (198 versus 196 respectively). This translated into 121 appendiceal procedures and 67 CRPM procedures, compared to 130 and 62 respectively in 2019-20. Considering the need to provide an additional 70 colorectal cancer resections whilst acting as a Covid “green site” for Greater Manchester, as well as the restrictions placed on the unit due to the Covid-19 pandemic, the team have worked extremely effectively in often very challenging circumstances over the last year. We have been delighted to welcome our 2 new consultant colleagues, Rebecca Fish who joined in October 2020 and Paul Sutton who joined in February 2021. In addition, we were joined by the 1 st ACPGBI/RCS Advanced Colorectal Malignancy fellow Sarah Hassan who is spending a year from October 2020 with us. We currently have 5 of our staff undertaking the ESPO fellowship in peritoneal surgery. Our results continue to indicate a high-quality service. For those with appendiceal neoplasia undergoing CRS and HIPEC, 77.9% have had a CC0/1 cytoreduction and patients with colorectal peritoneal metastases 83.6% had CC0/1 cytoreductions. Overall, our minor and major complication rates remain within and compare favourably to the internationally published data, with 29.2% having minor (G1/2) complications and 13.8% having G3/4 complications over the past 12 months. There was a single (0.52%) 90-day mortality. The unit has now performed 81 laparoscopic risk-reducing CRS+HIPEC with no complications in 80.3%, 6% G3/4 complications and no 90-day mortalities. 5-year overall survival in patients with benign appendiceal, malignant appendiceal and colorectal peritoneal metastases are calculated to be 86%, 64% and 37% respectively. We now have sufficient data to produce Kaplan Meier curves up to 72 months’ post treatment. As in the rest of the NHS, The Christie Hospital has been significantly affected by the Covid 19 pandemic. Thankfully there have been relatively few infected patients that have passed through the trust. By pursuing a very careful level of biosecurity that has included all staff wearing PPE in all clinical areas and undergoing weekly swabbing to detect Covid (PCR tests), all in-patients being swabbed within 5 days of any surgical procedure and then again on days 3 and 7 post-operation, admitting the majority of patients on the day of their surgery, prevention of all visitors and a dramatic increase in the number of remote consultations, using telephone and video communications, we have only needed to close the main ward on a single occasion for 8 days in December. We have had a successful year with regard to our research and training activities in spite of being unable to visit meetings or other units. Over 2020-2021 the group has obtained nearly £4million of funding for a variety of projects, both clinical and laboratory based. The unit has published 18 separate papers in peer reviewed journals since 2019. Our charity continues to provide us with significant support to allow us to develop our research and also to add to our patients’ and their families experience. MS Wilson May 2021

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