In the last 20 years the number of new cases of oesophageal cancer has increased greatly worldwide, while the
number of new cases of gastric cancer has decreased slightly. In the Netherlands in the last two decennia the number of patients seen with oesophageal cancers has tripled. It is not clear what specific causal factors can be attributed to this dramatic increase.
The 5 year life-expectancy rate for oesophageal cancer has improved due to a growth in the use of neoadjuvant therapy and the centralisation of oesophageal surgery. In spite of this a life expectancy of 5 years is low. An important study carried out in the Netherlands showed a prognosis of 5 years in 47% of patients after chemotherapy in combination with surgery.
The chance of surviving for 5 years after gastric cancer has not improved in the last 20 years. The 5 year survival rate is 30 – 50% depending on the location of the tumour. Many patients with oesophageal and gastric cancer develop metastases or a reforming of the tumour and it is difficult to predict which patients that will be.
The care of patients with oesophageal and gastric cancer demands specific expertise and a structured multidisciplinary approach. For this reason the care of these patients takes place principally in the UMC's and a few specialised non-academic centres in the Netherlands. Within the eight UMC's under the PSI umbrella, large scale prospective clinical data is joined to related biomaterial from a diverse range of disorders. As a relatively new Pearl, this Pearl is able to benefit from the usual logistical infrastructure within the UMC's and by doing so contributes to scientific development from within the PSI structure.
The purpose of the Pearl is to develop and implement an internationally recognised national network for the care of and research on patients with malignant tumours of the oesophagus and/or gastric. The scientific aim is to initiate and stimulate high quality scientific research. In this way the uniform collection of the clinical data is paired with analysis of biomaterial collected in a standardised manner.
The central scientific purposes are:
- to gain insight into the specific causal factors related to tumours of the oesophagus and gastric
- to evaluate and improve the response to (neoadjuvant) treatment
- to acquire more knowledge regarding the prognosis of patients with oesophageal and/or gastric tumours.