The Christie has a long and illustrious history with regards to the surgical management of cancer. The Christie specialises in 4 main areas of surgical treatment for cancer: colorectal/peritoneal (bowel and abdominal wall) tumours, urological (kidney, bladder, prostate, penile and testicular) tumours, gynaecological (ovary, uterus, cervix, ulval/labial) tumours skin/soft tissue tumours. There is also a very experienced team of plastic surgeons with specialist experience in reconstructive surgery following treatment for cancer.

Recent Submissions

  • Development and validation of a nomogram for prediction of survival and local control in laryngeal carcinoma patients treated with radiotherapy alone: a cohort study based on 994 patients.

    Egelmeer, A G T M; Velazquez, E R; de Jong, J M A; Oberije, C; Geussens, Y; Nuyts, S; Kremer, B; Rietveld, D; Leemans, C R; de Jong, M; et al. (2011-07)
    To advise laryngeal carcinoma patients on the most appropriate form of treatment, a tool to predict survival and local control is needed.
  • Skin-sparing mastectomy.

    Baildam, Andrew D; The Christie Hospital Cancer Centre, Manchester, United Kingdom. (2011-09)
  • What Three Wise Men have to say about diagnosis.

    Mani, Navin; Slevin, Nicholas J; Hudson, Andrew M; Department of Head and Neck Surgical Oncology, Christie Hospital, Manchester M20 4BX, UK. (2011)
  • Breast reconstruction following prophylactic mastectomy for smaller breasts: The superiorly based pectoralis fascial flap with the Becker 35 expandable implant.

    Ross, Gary L; Department of Plastic Surgery, The Christie, Wilmslow Road, Manchester M20 4BX, United Kingdom. (2012-01-09)
    INTRODUCTION: Immediate reconstruction using tissue expander/implants following prophylactic mastectomy for smaller breasts is a reliable means of providing similar size, shape and symmetrical reconstructions. The superiorly based pectoralis fascial flap allows an immediate reconstruction of the inferior pole and may eliminate the need for tissue expansion. METHODS: The superiorly based pectoralis fascial flap and implant was performed on 5 patients (10 breasts). The Becker 35 expandable implant was used in all cases and average size was 349 (range 290-400cc). Average age was 33 (range 21-43). The average BMI was 23 (range 20-26). One patient underwent further tissue expansion of the Becker 35 postoperatively. One patient developed a seroma in the abdominal fascial flap donor site that settled without the need for drainage. There were no other complications. CONCLUSION: The superiorly based pectoralis fascial flap provides a one-stop reconstruction of the lower pole and can eliminate the need for tissue expansion in patients with small breasts.
  • Apronectomy combined with laparotomy for morbidly obese endometrial cancer patients.

    Crosbie, Emma J; Estabragh, Z R; Murphy, James V; Ahmed, Ahmed S; Slade, Richard J; Department of Gynaecological Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. (2011-12)
    The surgical management of morbidly (BMI >40) and super obese (BMI >50) women with endometrial cancer is challenging. The aim of this study was to describe the short and long term outcomes of apronectomy combined with laparotomy for endometrial cancer staging and tumour debulking.
  • Insulin analogues and cancer risk: the emergence of second-generation studies.

    Renehan, Andrew G; School of Cancer and Enabling Sciences, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK. (2012-01)
    A number of observational studies have linked insulin glargine (A21Gly,B31Arg,B32Arg human insulin) with a putative increased cancer risk, particularly breast cancer, but many of these 'first generation' studies had study design and analysis flaws, and were inconclusive. A small number of 'second generation' studies are now emerging in which the applied pharmaco-epidemiological principles are more robust. For example, when Ruitar and colleagues (Diabetologia DOI: 10.1007/s00125-011-2312-4 ) focused specifically on breast cancer rather than all incident cancer risk, they were able to show a positive association with insulin glargine for breast cancer although there was no association with all incident cancer risk. A list of preferred qualities for pharmaco-epidemiological studies is presented.
  • The value of FDG positron emission tomography/computerised tomography (PET/CT) in pre-operative staging of colorectal cancer: a systematic review and economic evaluation.

    Brush, J; Boyd, K; Chappell, F; Crawford, F; Dozier, M; Fenwick, E; Glanville, J; McIntosh, H; Renehan, Andrew G; Weller, D; et al. (2011-09)
    In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384) in the colon and one-third (14,130) in the rectum. Treatment of cancers of the colon can vary considerably, but surgical resection is the mainstay of treatment for curative intent. Following surgical resection, there is a comprehensive assessment of the tumour, it's invasion characteristics and spread (tumour staging). A number of imaging modalities are used in the pre-operative staging of CRCs including; computerised tomography (CT), magnetic resonance imaging, ultrasound imaging and positron emission tomography (PET). This report examines the role of CT in combination with PET scanning (PET/CT 'hybrid' scan). The research objectives are: to evaluate the diagnostic accuracy and therapeutic impact of fluorine-18-deoxyglucose (FDG) PET/CT for the pre-operative staging of primary, recurrent and metastatic cancer using systematic review methods; undertake probabilistic decision-analytic modelling (using Monte Carlo simulation); and conduct a value of information analysis to help inform whether or not there is potential worth in undertaking further research.
  • The inpatient burden of abdominal and gynecological adhesiolysis in the US.

    Sikirica, V; Bapat, B; Candrilli, S D; Davis, K L; Wilson, Malcolm S; Johns, A; Shire Pharmaceuticals, Wayne, PA 19087, USA. (2011)
    Adhesions are fibrous bands of scar tissue, often a result of surgery, that form between internal organs and tissues, joining them together abnormally. Postoperative adhesions frequently occur following abdominal surgery, and are associated with a large economic burden. This study examines the inpatient burden of adhesiolysis in the United States (i.e., number and rate of events, cost, length of stay [LOS]).
  • Perfusion Estimated with Rapid Dynamic Contrast-Enhanced Magnetic Resonance Imaging Correlates Inversely with Vascular Endothelial Growth Factor Expression and Pimonidazole Staining in Head-and-Neck Cancer: A Pilot Study.

    Donaldson, Stephanie B; Betts, Guy N J; Bonington, Suzanne C; Homer, Jarrod J; Slevin, Nicholas J; Kershaw, Lucy E; Valentine, Helen R; West, Catharine M L; Buckley, David L; School of Cancer and Enabling Sciences, University of Manchester, Manchester, United Kindom; North Western Medical Physics, The Christie, Manchester, United Kingdom. (2011-05-04)
    PURPOSE: To analyze, in a pilot study, rapidly acquired dynamic contrast-enhanced (DCE)-MRI data with a general two-compartment exchange tracer kinetic model and correlate parameters obtained with measurements of hypoxia and vascular endothelial growth factor (VEGF) expression in patients with squamous cell carcinoma of the head and neck. METHODS AND MATERIALS: Eight patients were scanned before surgery. The DCE-MRI data were acquired with 1.5-s temporal resolution and analyzed using the two-compartment exchange tracer kinetic model to obtain estimates of parameters including perfusion and permeability surface area. Twelve to 16 h before surgery, patients received an intravenous injection of pimonidazole. Samples taken during surgery were used to determine the level of pimonidazole staining using immunohistochemistry and VEGF expression using quantitative real-time polymerase chain reaction. Correlations between the biological and imaging data were examined. RESULTS: Of the seven tumors fully analyzed, those that were poorly perfused tended to have high levels of pimonidazole staining (r = -0.79, p = 0.03) and VEGF expression (r = -0.82, p = 0.02). Tumors with low permeability surface area also tended to have high levels of hypoxia (r = -0.75, p = 0.05). Hypoxic tumors also expressed higher levels of VEGF (r = 0.82, p = 0.02). CONCLUSIONS: Estimates of perfusion obtained with rapid DCE-MRI data in patients with head-and-neck cancer correlate inversely with pimonidazole staining and VEGF expression.
  • The use of a combined radial forearm flap and radial fascial flap for layered dural lining and an orbital defect reconstruction.

    Bondin, D; Ross, Gary L; The Christie NHS Foundation Trust, Wilmslow Road, Manchester, UK. (2011-07)
    Variable reconstruction methods for craniofacial tumour resections have been devised with the primary purpose to improve quality of life and disease control. The reconstructive aims are to provide a watertight seal, cranial base support while allowing a cosmetically pleasing result. For defects involving the orbit, maintenance of the depth of the orbital socket remains important for prosthetic fitting and a bulky flap is not advisable for this purpose. This case demonstrates the use of a combination pericranial flap, radial forearm fascial flap and cutaneous radial forearm flap. We have been able to achieve a watertight seal of dura in multiple layers, provide adequate support to the cranial base while giving a non bulky reconstruction of the orbit.
  • Initial management through the anal cancer multidisciplinary team meeting.

    Renehan, Andrew G; O'Dwyer, Sarah T; Department of Surgery, Christie NHS Foundation Trust, Manchester, UK. (2011-02)
  • Re: Squamous cell carcinoma of the oral tongue in patients younger than 30 years.

    Mani, Navin; Homer, Jarrod J; Department of Head and Neck Surgery, The Christie Hospital, Manchester, UK (2011-02)
  • Management of local disease relapse.

    Renehan, Andrew G; O'Dwyer, Sarah T; Department of Surgery, Christie NHS Foundation Trust, Manchester, UK. (2011-02)
  • Height and cancer: consistent links, but mechanisms unclear.

    Renehan, Andrew G; School of Cancer and Enabling Sciences, University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK. (2011-08)
  • Mitochondrial DNA mutations in head and neck cancer are infrequent and lack prognostic utility.

    Challen, C; Brown, H; Cai, C; Betts, Guy N J; Paterson, I; Sloan, P; West, Catharine M L; Birch-Machin, M; Robinson, M; Centre for Oral Health Research, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne NE2 4BW, UK (2011)
  • The small-nucleolar RNAs commonly used for microRNA normalisation correlate with tumour pathology and prognosis.

    Gee, H E; Buffa, F M; Camps, C; Ramachandran, A; Leek, R; Taylor, M; Patil, M; Sheldon, H; Betts, Guy N J; Homer, J; et al. (2011-03-29)
    To investigate small-nucleolar RNAs (snoRNAs) as reference genes when measuring miRNA expression in tumour samples, given emerging evidence for their role in cancer.
  • Synchronous chemoradiotherapy in patients with locally advanced squamous cell carcinoma of the head and neck using capecitabine: a single-centre, open-label, single-group phase II study.

    Jegannathen, Apurna; Mais, Kathleen L; Sykes, Andrew J; Lee, Lip W; Yap, Beng K; Birzgalis, Andrew R; Homer, Jarrod J; Ryder, W David J; Slevin, Nicholas J; Department of Clinical Oncology, Christie NHS Foundation Trust, Manchester, UK. (2011-03)
    To evaluate the efficacy of concurrent oral capecitabine with accelerated hypofractionated radical radiotherapy in locally advanced squamous cell carcinoma of the head and neck (SCCHN).
  • Interpreting the epidemiological evidence linking obesity and cancer: A framework for population-attributable risk estimations in Europe.

    Renehan, Andrew G; Soerjomataram, Isabelle; Leitzmann, Michael F; Department of Surgery, The Christie NHS Foundation Trust, School of Cancer and Enabling Sciences, University of Manchester, UK. (2010-09)
    Standard approaches to estimating population-attributable risk (PAR) include modelling estimates of exposure prevalence and relative risk. Here, we examine the associations between body mass index (BMI) and cancer risk and how effect modifications of these associations impact on PAR estimates. In 2008, sex- and population-specific risk estimates were determined for associations with BMI in a standardised meta-analysis for 20 cancer types. Since then, refinements of these estimates have emerged: (i) absence of menopausal hormonal therapy (MHT) is associated with elevated BMI associations in post-menopausal breast, endometrial and ovarian cancers; (ii) current smoking attenuates the BMI associations in oesophageal squamous cell carcinoma, lung and pancreatic cancers; (iii) prostate screening attenuates BMI associations when all prostate cancers are considered together; and (iv) BMI is differentially associated with different histological subtypes within the same cancer group. Using secondary analyses of the aforementioned meta-analysis, we show 2-3-fold shifts in PAR estimations for breast and endometrial cancers depending on the MHT usage in European countries. We also critically examine how to best handle exposures (in this example, BMI distributions) and relative risk estimates in PAR models, and argue in favour of a counterfactual approach based around BMI means. From these observations, we develop a research framework in which to optimally evaluate future trends in numbers of new cancers attributable to excess BMI. Overall, this framework gives conservative estimates for PAR - nonetheless, the numbers of avoidable cancers across Europe through avoidance of excess weight are substantial.
  • The long road towards cancer prevention: 4 steps backward and 8 forward.

    Coebergh, Jan-Willem; Martin-Moreno, Jose M; Soerjomataram, Isabelle; Renehan, Andrew G; Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. (2010-09)
  • Joint practice guidelines for radionuclide lymphoscintigraphy for sentinel node localization in oral/oropharyngeal squamous cell carcinoma.

    Alkureishi, Lee W T; Burak, Zeynep; Alvarez, Julio A; Ballinger, James; Bilde, Anders; Britten, Alan J; Calabrese, Luca; Chiesa, Carlo; Chiti, Arturo; de Bree, Remco; et al. (2009-11)
    Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method of determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histological nodal staging and avoids over-treating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This article was designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. These guidelines were prepared by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial Committee.

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