Chicago Classification Criteria of Esophageal Motility Disorders (EPT)

Chicago Classification Criteria of Esophageal Motility Disorders Defined in High Resolution Esophageal Pressure Topography (EPT)

High resolution esophageal pressure topography (EPT) is an evolutionary technology incorporating the combination of high resolution manometry (HRM) and pressure topography plotting in the form of Clouse plots introduced in 2000 for the clinical evaluation of esophageal motility. Prior to that, EPT had been developed and utilized as a highly innovative research modality. The HRM Working Group first met in San Diego during DDW 2007 with the objective of adapting EPT to the clinical evaluation of esophageal motility. Since then, a series of HRM Working Group meetings have ensued on a more-or-less annual basis to review, critique, and plan the iterative process of developing a practical classification for esophageal motility disorders based on EPT-specific metrics and criteria. The classification scheme was initially branded 'The Chicago Classification' in 2007 following a series of seminal publications defining key EPT metrics and interpretation criteria optimized for clinical EPT studies emanating from a group of investigators at Northwestern University in Chicago. Since then, two iterations of the Chicago Classification have been published summarizing the incremental development of the classification scheme. The most recent meeting of the HRM Working Group was in Ascona, Switzerland in conjunction an international congress focused on the clinical evaluation of esophageal disease. This paper summarizes the Chicago Classification of esophageal motility disorders emanating from the meeting at the Ascona congress.

National Oesophago-Gastric Cancer Audit 2009

Second Annual Report

An audit of the care received by people with Oesophago-Gastric Cancer in England and Wales Second Annual Report

Dear Colleague,

We are pleased to announce the launch of the 2nd Annual Report of the National Oesophago-Gastric Cancer Audit which is available to download below.

It contains data on the demographics, referral, staging and treatment planning of over 11000 patients with oesophageal and gastric cancer. It also details early surgical outcomes and the early results of oncological and endoscopic and radiological palliative treatments. We are sure you will find the results of interest and relevance to your practice.

The Audit is ongoing and in the 3rd Report we hope to present risk-adjusted centre-specific long-term outcomes data. Please continue your participation and support in order to help us achieve this important goal.

If you have any questions regarding the Audit, please don’t hesitate to contact either Stuart Riley (BSG lead clinician – This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) or Tom Palser (clinical fellow – This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).

May we take this opportunity to thank you for your ongoing commitment.

Best wishes,

Tom Palser
Stuart Riley

National Oesophago-gastric Cancer Audit 3rd Annual Report


This is the final Annual Report of the first national audit of oesophago-gastric cancer in England and Wales; with data on over 17,000 patients it is the largest national audit of O-G cancer care and its acknowledged success has only been possible due to the tremendous effort of all those involved.

The Audit findings show that clinicians are providing a high quality of care for patients. In-hospital mortality for patients undergoing curative surgery is lower than the 2002 AUGIS audit and a greater number of curative procedures are being performed with a minimally invasive approach.

The Audit highlights Cancer Network variation and this should be examined in the reported use of EUS and staging laparoscopy, the use of palliative chemo- or radiotherapy and patient access to brachytherapy. Surgeons should monitor their pathology outcomes to ensure lymph node yield is adequate and meets the recommended guidelines.

It is disappointing that 6 cancer centres failed to participate fully and submitted data on less than 50 per cent of their patients. Their central role in the organisation of cancer care means that they should take the lead within their Cancer Networks for monitoring outcomes.

Cancer Networks and NHS trusts should use the findings from the Audit to review their outcomes, compare them against the National outcomes and ensure that they are meeting all the recommendations of the Audit, as outlined in the 3rd Annual Report.

Dr Stuart Riley, December 2010

National Oesophago-Gastric Cancer Audit: First Annual Report

We are pleased to present the first Annual Report of the National Oesophago-gastric Cancer Audit. The report identifies the improvements in patient care since the transformation of oesophago-gastric cancer services in England and Wales but also highlights areas in which further improvements are required. We hope you will find the recommendations of particular interest.

National Oesophago-Gastric Cancer Audit

Dear Colleagues,

The project is a collaborative venture between the BSG, Royal College of Surgeons, AUGIS and the National Cancer Audit Support Programme and is funded by the Healthcare Commission. We have begun an examination of existing datasets and are currently finalising a dataset to be used in the prospective component of the audit beginning October 2007. I suspect that many members will already be well aware of the audit through communications via the cancer networks.

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