SP6.5 Outcomes in Oesophagogastric Cancer up to 18 months following the COVID-19 pandemic

Abstract

Abstract Aims COVID-19 has negatively influenced oesophago-gastric (OG) cancer prognosis with stage migration described during the first six months of the pandemic. This study investigated the medium term effect of the national lockdown on diagnosis, management and outcomes. Methods A retrospective cohort study of all newly diagnosed OG cancers in a single regional MDT between 1 October 2019 and 30 September 2021. Patients were divided into four 6-month period based upon date of first MDT discussion in relation to the first UK national lockdown: pre-lockdown, 0-6, 6-12 and 12-18 months post-lockdown. Electronic health records were reviewed and results compared. Result 664 patients with OG cancers were included. Median age was 71 years (62-77) and 445 (67%) were male. 502 (76%) had adenocarcinoma. Compared with pre-lockdown, patients in the 0-6-months group were significantly older (p<0.05), symptomatic (p<0.05), and had stage migration with increased metastatic disease (p<0.05), palliative treatment intent (p<0.001) and reduced survival (p<0.05). Compared with pre-lockdown, there was no difference in patients presenting in the 12-18 months group in terms of age (p=0.927), sex (p=0.461), performance status (p=0.666), presence of metastatic disease (p=0.971) and treatment intent (p=0.123). However, more patients in this group were symptomatic (p=0.025), presented as emergencies (p=0.032) and had a poorer overall survival (p<0.05). Conclusion Patients presenting 12-18 months after the initial lockdown are still experiencing poorer overall survival than those pre-pandemic. Identification and addressment of the factors contributing to the continued poor outcomes following COVID-19 is urgently required to return overall patient survival to the pre-pandemic level.