Esophagogastric Cancer Surgical Intervention

This study will recruit adult patients referred to the University Hospitals of Leicester NHS Trust Esophagogastric Cancer Service with a confirmed diagnosis of esophagogastric cancer, deemed suitable for an esophagectomy or total gastrectomy. The inclusion criteria are adults over 18 years of age with a confirmed diagnosis of esophagogastric cancer who are undergoing a planned curative surgical treatment esophagectomy (Ivor Lewis, three stage, or transhiatal resection) or total gastrectomy with placement of jejunostomy feeding tube. Patients will provide written informed consent for participation in the study.
The exclusion criteria include an inability to provide informed written consent, patients in whom artificial nutrition support at home is deemed inappropriate by either the patient or healthcare team (due to safety issues or home circumstances) and patients undergoing subtotal gastrectomy (would not usually have jejunostomy tube fitted).
Participation in this study does not exclude participation in national trials of perioperative chemotherapy. Due to the different scheduling arrangements the two treatment interventions (chemotherapy and jejunostomy feeding) would not be administered concurrently. The time frame for the administration of preoperative chemotherapy is prior to the planned six week jejunostomy feeding period, and the time frame for the administration of postoperative chemotherapy is after completion of the planned six week jejunostomy feeding. Some participants and their carer or partner will also participate in the qualitative study, for which the only additional criterion is a willingness to participate.