Christopher John Peters

Christopher John Peters
Imperial College London | Imperial · Division of Surgery

MBChB, BSc (Hons), FRCS (Gen Surg), PhD

About

68
Publications
3,850
Reads
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897
Citations
Additional affiliations
April 2014 - present
Imperial College London
Position
  • Lecturer
September 2006 - April 2010
University of Cambridge
Position
  • PhD Student
September 1996 - July 2002
University of Leeds
Position
  • PhD Student

Publications

Publications (68)
Article
Background and aim The lack of a fast and accurate intraoperative tumour margin assessment tool contributes to high positive circumferential resection margin rates for oesophageal and gastric cancers, which is associated with local recurrence and poor long-term survival. Diffuse reflectance spectroscopy (DRS) can provide non-invasive, accurate, and...
Article
Full-text available
Oesophageal adenocarcinoma (OAC) provides an ideal case study to characterize large-scale rearrangements. Using whole genome short-read sequencing of 383 cases, for which 214 had matched whole transcriptomes, we observed structural variations (SV) with a predominance of deletions, tandem duplications and inter-chromosome junctions that could be ide...
Article
Background: Oesophageal adenocarcinoma poses a significant global health burden, yet the staging used to predict survival has limited ability to stratify patients by outcome. This study aimed to identify published clinical models that predict survival in oesophageal adenocarcinoma and to evaluate them using an independent international multicentre...
Article
Preoperative cardiopulmonary exercise testing (CPET) provides an objective assessment of aerobic fitness in patients undergoing surgery. While peak oxygen uptake during exercise (VO2peak) and anaerobic threshold have demonstrated a moderate correlation with the development of complications following esophagectomy, no clinically useful threshold val...
Article
Significance: Diffuse reflectance spectroscopy (DRS) allows discrimination of tissue type. Its application is limited by the inability to mark the scanned tissue and the lack of real-time measurements. Aim: This study aimed to develop a real-time tracking system to enable localization of a DRS probe to aid the classification of tumor and non-tum...
Article
Background Diffuse reflectance spectroscopy (DRS) is a technique that allows discrimination of normal and abnormal tissue based on spectral data. It is a promising technique for cancer margin assessment. However, application in a clinical setting is limited by the inability of DRS to mark the tissue that has been scanned and its lack of continuous...
Article
Full-text available
Aim Cancers of the upper gastrointestinal (GI) tract remain a major contributor to the global cancer risk. Surgery aims to completely resect tumour with clear margins, whilst preserving as much surrounding tissue. Diffuse reflectance spectroscopy (DRS) is a novel technique that presents a promising advancement in cancer diagnosis. We have developed...
Article
Aim Gastrointestinal (GI) cancers account for 26% of global cancer incidence with prevalence projected to rise exponentially due to the ageing population and lifestyle choices. Surgical resection is the mainstay of treatment to remove the cancer in its entirety to achieve an R0 resection. Positive margins, when cancerous tissue has been left in sit...
Conference Paper
Colorectal cancer incidence is increasing globally and represents the fourth leading cause of death due to cancer. In this study, a diffuse reflectance spectroscopic fibre probe is employed for tissue characterization. DRS fibre probes leave no marks on tissue and thus imaging and tracking its tip during tissue scanning would enable the localizatio...
Article
Full-text available
Hamman’s syndrome, first described by Dr Louis Hamman in 1939, is a syndrome of spontaneous pneumomediastinum and subcutaneous emphysema. It is a rare complication of diabetic ketoacidosis (DKA), and self-resolves within days with conservative management. Limited awareness about this condition may lead to an initial misdiagnosis of secondary pneumo...
Article
Background Prognostication in oesophageal cancer on the basis of preoperative variables is challenging. Many of the accepted predictors of survival are only derived after surgical treatment and may be influenced by neoadjuvant therapy. This study aims to explore the relationship between pre-treatment endoscopic tumour morphology and postoperative s...
Conference Paper
Introduction Boerhaave syndrome is associated with high morbidity and mortality rates. Outcomes are dependent on early recognition and intervention. Until recently, surgery has been the mainstay of management. However, with recent advances in therapeutic endoscopy, there has been increasing interest in endoscopic options, including endoluminal vacu...
Article
Full-text available
Cancers occurring at the gastro‐esophageal junction (GEJ) are classified as predominantly esophageal or gastric, which is often difficult to decipher. We hypothesised that the transcriptomic profile might reveal molecular subgroups which could help to define the tumor origin and behaviour beyond anatomical location. The gene expression profiles of...
Presentation
Full-text available
1st Prize Award (presented by Ms. L.G. Tincknell) *Joint first authors between Mr. W. Waldock and F.B. Avila-Rencoret
Article
A 27-year-old man presented to a major trauma centre with two posterolateral thoracic stab injuries over the right scapula and thoracoabdominal junction. He was tachycardic and hypotensive with a chest X-ray revealing a large right-sided tension haemothorax, requiring insertion of two intercostal chest drains. A subsequent CT scan demonstrated a gr...
Article
Full-text available
Background: The current TNM staging system for oesophageal adenocarcinoma (OAC) has limited ability to stratify patients and inform clinical management following neo-adjuvant chemotherapy and surgery. Results: Functional genomic analysis of the gene expression data using Gene Set Enrichment Analysis (GSEA) identified GLUT1 as putative prognostic...
Article
Introduction: Esophageal and gastric cancer have a poor prognosis and surgical intervention is associated with considerable morbidity, highlighting the need for careful preoperative assessment. The Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary exercise testing (CPET) can assess preoperative fitness. This study aims to investigate their...
Article
Full-text available
BACKGROUND: This multicentre cohort study sought to define a robust pathological indicator of clinically meaningful response to neoadjuvant chemotherapy in oesophageal adenocarcinoma. METHODS: A questionnaire was distributed to 11 UK upper gastrointestinal cancer centres to determine the use of assessment of response to neoadjuvant chemotherapy. Re...
Article
Full-text available
Key Clinical Message Aorto‐esophageal fistula is often a terminal event in many patients. The commonest causes are thoracic aortic aneurysm and esophageal malignancy. To achieve a good outcome in this condition, a MDT approach is required that combines the expertize of vascular surgeons, radiologists, and emergency physicians.
Chapter
The epidemic of obesity affects almost all countries of the developed world and has led to a dramatic increase in the number of bariatric procedures worldwide. In the United Kingdom (UK), the adoption of weight loss surgery has been via dedicated regional bariatric centres, and there is a drive for shorter stays in hospital after surgery. Both thes...
Article
Full-text available
The molecular genetic relationship between esophageal adenocarcinoma (EAC) and its precursor lesion, Barrett's esophagus, is poorly understood. Using whole-genome sequencing on 23 paired Barrett's esophagus and EAC samples, together with one in-depth Barrett's esophagus case study sampled over time and space, we have provided the following new insi...
Article
Full-text available
Cancer genome sequencing studies have identified numerous driver genes, but the relative timing of mutations in carcinogenesis remains unclear. The gradual progression from premalignant Barrett's esophagus to esophageal adenocarcinoma (EAC) provides an ideal model to study the ordering of somatic mutations. We identified recurrently mutated genes a...
Article
Full-text available
A 63-year-old patient was diagnosed with acute jejunal diverticulitis and possible perforation. The patient was taken to the operating room for an exploratory laparotomy where a suspected segment of small bowel was resected. However, the surgical team was unsure whether the resected segment was the definite location of the perforation. A novel tech...
Article
Full-text available
Objective: The success of personalised therapy depends on identification and inhibition of the oncogene(s) on which that tumour is dependent. We aimed to determine whether a receptor tyrosine kinase (RTK) array could be used to select the most effective therapeutic strategies in molecularly heterogeneous oesophago-gastric adenocarcinomas. Design:...
Article
Full-text available
Although most cases of acute pancreatitis are attributed to gallstones or alcohol, many remain idiopathic. The authors describe a case of acute pancreatitis in a 75-year-old gentleman who presented with acute epigastric pain, fevers and shortness of breath. Serum amylase was 2164. CT showed free mesenteric air, and a partly cystic/partly gas-contai...
Article
Full-text available
Cysts of the adrenal gland are rare and are usually discovered incidentally. Large adrenal cysts can however present with severe abdominal pain and can be complicated by haemorrhage, rupture or infection. Adrenal pseudocysts appear to result from haemorrhage within a normal adrenal gland and can expand to accommodate massive amounts of fluid.We rep...
Article
Venous thromboembolism (VTE) is a frequent cause of morbidity and mortality in patients with cancer and those having chemotherapy. However, the incidence of VTE during radical treatment for patients with oesophago-gastric cancer is poorly documented. The incidence of VTE was assessed in 200 consecutive patients with oesophago-gastric cancer having...
Article
Full-text available
IntroductionThe future success of individualised, molecular targeted therapy will depend on identification and thence inhibition of the oncogene(s) on which that tumour is dependent for survival. Gastro-esophageal tumours are common, lethal and molecularly heterogeneous. Currently chemotherapy relies on generic regimens and neo-adjuvant treatment o...
Article
The incidence of esophageal and junctional adenocarcinoma has increased 6-fold in the past 30 years and 5-year survival remains approximately 20%. Current staging is limited in its ability to predict survival which has ramifications for treatment choices. The aim of this study was to generate and validate a molecular prognostic signature for esopha...
Conference Paper
Full-text available
Introduction The incidence of oesophageal and junctional adenocarcinoma has increased sixfold in the last 30 years and 5-year survival remains <14%. Most patients present with advanced disease and current staging is limited in its ability to predict survival. We aimed to generate and externally validate a molecular prognostic signature for oesophag...
Article
The number of patients on the UK and the USA liver transplant list is increasing. As size match is an important factor in the UK organ allocation, we studied the effect of recipient size on liver transplantation in the UK and the USA. The UK Transplant and United Network for Organ Sharing databases were used to assess difference in access to transp...
Article
Oesophageal adenocarcinoma is the commonest oesophageal malignancy in the West, but is staged using a system designed for squamous cell carcinoma. The aim was to develop and validate a staging system for oesophageal and junctional adenocarcinoma. Patients with oesophageal adenocarcinoma (Siewert types I and II) undergoing oesophagectomy with curati...
Article
The incidence of oesophageal adenocarcinoma has increased dramatically in the Western world over the past two decades. Owing to its dismal 5-year prognosis in advanced stages, early diagnosis is required in order to improve survival rates. Barrett's oesophagus (Barrett's) has been recognised as a pre-cancerous condition generally associated with ch...
Article
The frequency of oesophageal adenocarcinoma is increasing in Western countries for unknown reasons, and correlates with a corresponding increase in the pre-malignant condition, Barrett's Oesophagus, which raises the risk of adenocarcinoma by some 40- to 125-fold. We have examined how disease progression correlates with changes in expression of the...
Article
Oesophageal adenocarcinoma is an increasingly common cancer with a poor prognosis. It develops in a stepwise progression from Barrett's metaplasia to dysplasia, and then adenocarcinoma followed by metastasis. To outline the key molecular changes in oesophageal adenocarcinoma and to summarize the chemopreventative and therapeutic strategies proposed...
Article
As the result of the widening gap between supply and demand of organs for liver transplantation, efforts to improve allocation have become an increasingly important yet controversial subject. The MELD score has been adopted in the USA but its usefulness has rarely been examined in Europe. We carried out an intention to treat analysis of 422 patient...
Article
Ligasure haemorrhoidectomy has short-term benefits over conventional diathermy haemorrhoidectomy. The current study aimed to determine the long-term efficacy of Ligasure haemorrhoidectomy. Forty patients, previously randomised to Ligasure or diathermy haemorrhoidectomy in 2002, were invited to participate in the study. Haemorrhoidal symptoms and pa...
Article
Editor—Ali et al reported on bad press for doctors.1 In a research project with the BMA's public affairs division I analysed all reports on medicine and health science in the 21 major British newspapers published over a period of one month. Altogether 799 articles were coded into a database and graded according to whether they were positive, negat...

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Projects

Projects (2)
Project
Neoadjuvant chemoradiotherapy has been shown to increase overall survival in a number of gastrointestinal cancers. However, tumour regression can make it difficult to distinguish between tumour and scar tissue. This means either more tissue is resected than required, resulting in increased morbidity, or there is a positive circumferential resection margin (CRM), leading to worse survival. The current gold standard for intraoperative CRM assessment is frozen section, which is slow, subjective and expensive. Therefore, a technology to intraoperatively assess CRMs is highly desirable. This project aims to determine if diffuse reflectance spectroscopy (DRS) can distinguish between tumour, scar-non-tumour and normal tissue.