232. EVALUATING THE CORRELATION BETWEEN CLINICAL AND PATHOLOGICAL TUMOUR AND NODAL STAGING IN OESOPHAGEAL CANCER –A 12 YEAR ANALYSIS

Abstract Oesophageal cancer is clinically staged using the TNM classification by modalities such as CT, PET-CT and endoscopic ultrasound. This is used to assess and guide oncological treatment in the form of neoadjuvant chemotherapy, radiotherapy and surgery. Following neoadjuvant therapy and/or surgery the resected specimen is analysed and given a final histological stage. The purpose of this study was to evaluate the accuracy and variation in pre-operative (radiological) stage from the final histopathological stage. This retrospective study was conducted using an electronic database containing pre- and post-operative TNM staging information on all patients undergoing elective oesophagectomies from April 2009 to December 2021 at a single tertiary upper gastrointestinal cancer centre. 568 patients underwent Ivor Lewis oesophagectomies. The median age was 63 years old (45–82) with M:F 1.78:1. The median length of stay (LOS) was 13 (3–148) days. Results on table attached. Based on our data, there is an observed significant down-staging amongst tumours with higher T and N stages from their predicted pre-operative stage to the final TNM stage allocated after histopathology review. This reflects the continued value of neoadjuvant chemo(radio)therapy. Early T1N0 tumours still appear challenging to accurately stage pre-operatively, hence adjuncts such as endoscopic ultrasound remain crucial in guiding management.