Grant: Planning and Dissemination Grant - Institute Community Support

Gastric cancer outcomes in North America lag significantly behind those in Asia, with 5-year survival over 4 times more likely in the East when compared to the west. Known differences between the surgical techniques D1 and D2 lymph node dissection (LND) could explain this gap in survival. D2 LND is significantly more technically demanding than a D1 LND and has long been considered standard of care in Asia for the definitive surgical treatment of gastric cancer and only recently recommended in both North American and Europe. The rate of D2 LND in North America, however, remains low. In Ontario, our group has shown that less than 10% of the gastrectomies performed occur with a D2 LND. Not only are the rates of D2 LND in Ontario low, but there are also significant knowledge gaps relating to the appropriate surgical management of the disease. We propose an educational course to provide practicing surgeons in Ontario an update regarding the current guidelines for the management of gastric cancer and teach them the technique for D2 LND. National and international faculty who are experts in the surgical care of patients with gastric cancer have been recruited, and committed to participate in the delivery of course. The first day of the course will focus on the multi-disciplinary management of patients with gastric cancer. Topics covered will include considerations for chemotherapy and radiation treatment, clinical trials, and complex tumours. The second day of the course will include video-review of operations, discussion regarding anatomic considerations, and mentored practice of D2 LND on cadaver models. We expect that the outcome of the course will be an improvement in the management of patients with gastric cancer in Ontario. We believe that our intervention will enhance surgeons' understanding of the appropriate multidisciplinary care of the disease, and provide them with the technical skills necessary to improve the quality of their lymph node dissections.