Cancers that occur at the junction between the oesophagus (gullet) and the stomach are called gastro oesophageal junction (GOJ) adenocarcinomas. They are 6 times more common than they were 30 years ago and have a very poor outcome (only 1 in 5 patients will survive five years). We have previously developed a new way of determining how advanced a patient’s OJ adenocarcinoma is (this is called staging) using both the physical features determined by the radiology tests and the molecular features of the cancer. This system works significantly better than the existing way we stage these cancers. However this new system was developed using patients who had already had their surgery. The current study now wants to test it on patients at the beginning of their treatment (termed prospectively).
The patients’ management will not differ from current practice but as well as looking at the features used for staging at the moment they will also record the new system in parallel. They will also test samples of the cancer, which are already routinely taken, for the molecular changes thought to predict survival. After this patients will undergo the standard treatment at.
It will then be possible to determine both how practical the new system is and how good it is at predicting survival. If it can be proved that the revised staging system, using both the physical features of the tumour and the olecular changes, can accurately predict outcome this will allow us to give far better information to patients about their chance of a cure but also it will also
allow treatments to be targeted at those who will benefit the most. This study will not affect the care a patient receives in any way. They will undergo the same staging (CT scan, Endoscopic ultrasound, PET scan) as they would do if not in this study. The only difference is the research team will be recording the staging of their tumour using the new system as well as the existing system. All decisions about treatment will be based on the current system.