225 Assessing Anaemia Management in Oesophagogastric Cancer Patients: Are We Meeting ESMO Standards?

Abstract Objective The European Society of Medical Oncology (ESMO) recommends a target haemoglobin (Hb) of 12 g/dL in patients receiving active cancer treatment. Untreated anaemia may impair treatment response and reduce survival. This study evaluated the identification and management of anaemia in patients with resectable oesophagogastric cancer at Oxford University Hospitals (OUH) and assessed whether anaemia contributed to delays in chemotherapy or surgery, aiming to identify areas for pathway improvement. Method A retrospective review was conducted over four months (September–December 2024), including 39 patients. Longitudinal data on Hb, MCV, and haematinics were collected at key milestones: referral, pre-neoadjuvant chemotherapy (pre-NAC), post-NAC, and pre-surgical assessment. Referrals and treatment for anaemia (oral/IV iron or transfusion) were reviewed by source, timing, and delivery mode (elective/emergency). Results At baseline, 18/39 (46%) patients were anaemic, and 11/39 (28%) met ESMO criteria for treatment. Of these, 8/11 (73%) received treatment (4 oral iron, 4 iron infusions). Prior to surgery, anaemia was present in 25/36 (69%), with 9/36 (25%) meeting treatment criteria. Of those, 5/9 (56%) did not receive treatment prior to surgery. Management was initiated by pre-op, oncology, and surgical teams. Three patients did not receive treatment due to limited capacity. One required emergency admission. No surgical delays occurred. Conclusions Anaemia is common and worsens during neoadjuvant chemotherapy for oesophagogastric cancer. Many patients remain untreated despite meeting ESMO criteria. Routine haematinics at defined milestones may prompt earlier intervention. A protocol-driven, MDT-embedded approach would help optimising treatment of anaemia prior to definitive surgery.