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Background Surgery remains the fundamental modality for achieving disease cure in patients with oesophageal adenocarcinoma In those with locally advanced disease, in the UK, is usually used in conjunction with perioperative chemotherapy as per the Magic trial. Not all patients manage to progress to the adjuvant component of the chemotherapy regimen, and its impact on outcome has not been determined. The aim of this review was to compare outcomes in those patients that received neoadjuvant treatment only with those that received neoadjuvant and adjuvant chemotherapy. Methods A retrospective review of patients who underwent treatment with curative intent for locally advanced oesophageal adenocarcinoma between 2006 to 2016 at a single institution was performed. Outcomes of patients who were staged T3 and above or had evidence of nodal disease and received perioperative chemotherapy were reviewed. Outcomes were stratified according to whether patients received only neoadjuvant chemotherapy or both neoadjuvant and adjuvant chemotherapy. Results A total of 413 patients underwent transthoracic oesophagectomy and two field lymphadenectomy with perioperative chemotherapy. 276 (67%) received only neoadjuvant chemotherapy, with 137 (33%) receiving at least one cycle of adjuvant chemotherapy. Pathological staging was comparable between groups (P  = 0.17). Overall estimated median survival was 30 months (neoadjuvant only) Versus 37 months (Both) P  = 0.2. In patients that were found to be node positive median survival was 22 months (neoadjuvant) versus 28 months (both) P  = 0.21. For node negative patients median survival was not reached in both groups. Conclusion These results indicate a trend towards improved survival with the addition of adjuvant chemotherapy. This may be of greater impact in those patients with nodal involvement. Further studies are required to fully evaluate the impact of adjuvant chemotherapy in patients surgically treated for oesophageal cancer. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Background Oesophageal cancer incidence has increased over the last decade in the UK, particularly in older patients. Surgery, with or without perioperative chemotherapy, remains the gold standard treatment for patients with potentially curable disease. Currently, 41% of new cases of oesophageal cancer are in patients aged over 70. However, only 10% underwent surgery compared to 25% of those aged under 70. Concerns exist that advanced age may prejudice treatment decisions. The aim of our review is to evaluate the impact of age on outcomes in those undergoing planned curative treatment for oesophageal cancer. Methods A retrospective review of patients undergoing oesophagectomy for carcinoma between 2006 to 2016 at a single institution was performed. Patients were divided into two cohorts based on age at the time of diagnosis; under 70 years (Group A) and over 70 (Group B). Patients underwent a standardised staging protocol and treatment was decided by a multi-disciplinary team. Oesophagectomy was performed using a transthoracic approach with two field lymphadenectomy and perioperative chemo (radio) therapy used in those patients with locally advanced disease who were fit enough. Results There were 555 patients in Group A and 241 in Group B. Adenocarcinoma was the prevalent histological subtype in both cohorts: 76% (423) in Group A and 68% (165) in Group B. Median age at the time of diagnosis was 62 in Group A versus 74 in Group B. In Group A, 12% (18/343) did not receive neo-adjuvant treatment for locally advanced cancer versus 47% (101/212) in Group B (P  < 0.001). Median hospital stay was longer in Group B (18 v 15 days P  = 0.02). There was no significant difference in hospital mortality (Group A 1% vs Group B 2.4% P  = 0.37) and major complication rate (Group A 14% vs Group B 20% P  = 0.31). Two-year survival was 66% (adenocarcinoma) and 78% (SCC) in Group A compared to 60% (adenocarcinoma) and 64% (SCC) in Group B. Conclusion These results demonstrate that patients over 70 can be treated successfully with minimal additional risk to morbidity and mortality. However, these patients are more likely to be denied neoadjuvant treatment which may compromise their long-term outcomes. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]