John Findlay wins Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) Prize

The CRUK Oxford Centre is delighted to announce that the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) recently awarded Centre member, John Findlay, its prestigious British Journal of Surgery prize for the best free paper presented at the 2017 AUGIS Scientific Meeting in Cork, Ireland. John is a Specialty Registrar in General Surgery in the Oxford Deanery, and a Senior Clinical Research Fellow in OesophagoGastric Surgery informatics at the NIHR Oxford Biomedical Research Centre.
The prize was awarded for his paper ’Staging gastric cancer with 18F-FDG PET-CT identifies frequent unsuspected metastases and patients of high risk of incurable disease, early recurrence and death’.
This study included 279 consecutive patients with stomach cancer (non-junctional gastric adenocarcinoma) who as part of their treatment at Oxford University Hospitals NHS Foundation Trust underwent a staging PET-CT scan. At present, there is little evidence that routinely using PET-CT in this context is useful. Consequently, it is not recommended by national and international guidelines. However, the Oxford OesophagoGastric Centre has routinely used cutting edge 18F-FDG PET-CT scanning technology for both oesophageal (gullet) and stomach cancer for more than 10 years. The test uses radio-labelled glucose molecules, which tend to concentrate in cancer tissues. These tissues then become visible, or ‘avid’, on the scan and may help provide information about the behaviour of cancer.
In the largest and most contemporary series to date, PET-CT was shown to detect incurable or metastatic cancer in approximately 7% of patients, despite their preceding CT scan being clear. Furthermore, the subgroup of patients who also had avid lymph nodes appeared to be at increased of such incurable disease, and also early cancer recurrence and death after surgery. This builds on previous findings from John’s research in oesophageal and gastro-oesophageal junctional cancer, and suggests PET-CT should also be considered routinely for patients with gastric cancer.
John is now exploring whether PET-CT should also be repeated before surgery if patients receive chemotherapy, and whether the response of avid nodes to this chemotherapy allows clinicians to monitor its effectiveness. He commented that he was honoured to receive this prize on behalf of his collaborators, and hopes that these findings will be able to improve staging and counselling for patients with stomach cancer, and also help identify patients who might benefit from additional investigations.