414 The Timing of Adjuvant Therapy Following Oesophago-Gastric Cancer Resection

Abstract Aim The recommendation is to deliver adjuvant therapy within 3 months of oesophago-gastric cancer resection. The timing of adjuvant therapy commencing was assessed between two study periods. Method Demographic and timing data was collated for elective oesophago-gastric cancer resections (excluding GISTs) between February 2023-February 2024 for round 1 and March 2024 - March 2025 for round 2. The interventions included collaboration with the relevant specialities on improving the administrative and logistical challenges in the pathway to adjuvant therapy. Results There were 55 cases in round 1 and 38 cases in round 2 with a median age of 69 (43-86) and 68 (43-84) respectively. The median (IQR) length of stay was 9.00 (16) days and 8.50 (11) days in round 2. 58% of patients in round 1 commenced adjuvant therapy; this was 71% in round 2. The median (IQR) time between surgery and the commencing adjuvant therapy was 85.00 (40.25) days in round 1 and 82.00 (23.00) days in round 2. 59% of suitable patients commenced adjuvant therapy within 3 months of surgery in round 1 and this was 70% in round 2. There were no statistically significant differences in median time or percentage of adjuvant therapy within 3 months between the two rounds. In round 1, the main barriers to adjuvant therapy commencing promptly were slow postoperative recovery (30.8%). In round 2, delays in receiving an oncology appointment contributed the most (37.5%). Conclusions Barriers to the timely commencement of adjuvant therapy include surgical complications, nutritional deficiencies, and logistical challenges.