P1.162. Does Deprivation Drive Outcomes? Socioeconomic Factors in Esophageal Cancer Resections

Abstract

Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer Background Esophageal cancer incidence is higher in socioeconomically deprived populations. While deprivation is linked to established risk factors, its impact on tumour stage, comorbidity burden, and postoperative outcomes among patients undergoing esophagectomy remains unclear. This study assessed whether socioeconomic deprivation influences perioperative and oncological outcomes following Ivor Lewis esophagectomy. Methods This retrospective study included all patients undergoing Ivor Lewis esophagectomy for cancer at a single high-volume centre between October 2019 and May 2025. Socioeconomic status was measured using the English Index of Multiple Deprivation. One patient residing in Scotland was excluded. Associations between deprivation and demographics, tumour characteristics, comorbidity burden, length of stay, postoperative complications, and mortality were analysed. Spearman correlation was used for continuous variables, ordinal regression for tumour stage, and binary logistic regression for categorical outcomes, including complications and mortality. Statistical significance was defined as p<0.05. Results Of 341 patients, 340 were analysed. Deprivation showed no correlation with age (r=0.075, p=0.169), body mass index (r=−0.068, p=0.213), or Charlson comorbidity index (r=−0.02, p=0.732). No association was observed with tumour histology (adenocarcinoma OR 1.04, p=0.711), receipt of neoadjuvant therapy (OR 1.06, p=0.616), or clinical stage (OR 0.95, p=0.188). Length of stay was not correlated with deprivation (r=−0.037, p=0.496). Deprivation was not associated with major complications (Clavien–Dindo ≥III; OR 0.93, p=0.373), in-hospital mortality (OR 0.99, p=0.978), 30-day mortality (OR 1.79, p=0.091), or 90-day mortality (OR 1.10, p=0.65). Conclusion Socioeconomic deprivation was not associated with tumour stage, comorbidity burden, or postoperative outcomes following Ivor Lewis esophagectomy. These findings suggest equitable surgical care delivery once patients reach operative treatment. Inequalities in esophageal cancer outcomes are likely driven by factors occurring earlier in the disease pathway, emphasising the importance of prevention, early detection, and timely referral.