Alberto Carmona-Bayonas1, Paula Jiménez-Fonseca2, Isabel Echavarria3, Manuel Sánchez Cánovas4, Gema Aguado3, Javier Gallego5, Ana Custodio6, Raquel Hernández7, Antonio Viudez8, Juana María Cano9, Eva Martínez de Castro10, Ismael Macías11, Alfonso Martín Carnicero12, Marcelo Garrido13, Monserrat Mangas14, Felipe Álvarez Manceñido15, Laura Visa16, Aitor Azkarate17, Avinash Ramchandani18, Ana Fernández Montes19, Federico Longo20, Ana Sánchez21, Paola Pimentel22, María Luisa Limón23, David Arias19, Diego Cacho Lavin10, Rodrigo Sánchez Bayona24, Paula Cerdá25, Pilar García Alfonso3. 1. Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, Murcia, Spain. Electronic address: alberto.carmonabayonas@gmail.com. 2. Medical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 3. Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain. 4. Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, Murcia, Spain. 5. Medical Oncology Department, Hospital Universitario de Elche, Elche, Spain. 6. Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain. 7. Medical Oncology Department, Hospital Universitario de Canarias, Tenerife, Spain. 8. Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain. 9. Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. 10. Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 11. Medical Oncology Department, Hospital Universitario Parc Tauli, Sabadell, Spain. 12. Medical Oncology Department, Complejo Hospitalario San Millán, Logroño, Spain. 13. Medical Oncology Department, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile. 14. Medical Oncology Department, Hospital Galdakao-Usansolo, Galdakao-Usansolo, Spain. 15. Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 16. Medical Oncology Department, Hospital Universitario El Mar, Barcelona, Spain. 17. Medical Oncology Department, Hospital Universitario Son Espases, Mallorca, Spain. 18. Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. 19. Medical Oncology Department, Complejo Hospitalario de Orense, Orense, Spain. 20. Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. 21. Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain. 22. Medical Oncology Department, Hospital Santa Lucia, Cartagena, Spain. 23. Medical Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain. 24. Medical Oncology Department, Clínica Universidad de Navarra, Pamplona, Spain. 25. Medical Oncology Department, Centro Médico Tecknon, Barcelona, Spain.
Abstract
INTRODUCTION: The effect of surgery for metastases in patients with esophagogastric cancer is unknown, given the lack of randomized clinical trials; likewise, the criteria for selecting eligible patients remain to be determined. METHODS: This registry evaluates the results of patients with advanced adenocarcinoma of the stomach, distal esophagus, or gastro-esophageal junction from 32 centers. To assess selection criteria and prognostic factors, a state arrival extended Markov proportional hazards (PH) model was used. RESULTS: 1792 subjects were analyzed, 5% of whom (n = 92) underwent surgery for metastasis. The most common surgeries were peritoneal (29%), hepatic (24%), and distant lymph nodes (11%). Subjects chosen for metastasectomy had higher survival rates, HR 0.34 (95% CI, 0.06-0.80, p = 0.021). Patients who underwent surgery had a mOS since metastasectomy of 16.7 months (95% CI, 12.5-22.4). The 1- and 3-year relapse rates following R0 resection were 58% and 65%, respectively. Median time since R0 metastasectomy until relapse was 8.4 months (95% CI, 7.6-23.7). The 3-year OS after surgery was 30.6% (95% CI, 19.3-40.4). Duration of chemotherapy prior to surgery (months) increased mortality (HR 1.04 [95% CI, 1.01-1.07]), p = 0.009. The only significant interaction involved the use of anti-HER2 therapy. CONCLUSION: The AGAMENON registry suggests that subjects with limited metastatic disease, selected on a clinical basis, can benefit from early surgeries. Prospective trials are needed to confirm these data.
INTRODUCTION: The effect of surgery for metastases in patients with esophagogastric cancer is unknown, given the lack of randomized clinical trials; likewise, the criteria for selecting eligible patients remain to be determined. METHODS: This registry evaluates the results of patients with advanced adenocarcinoma of the stomach, distal esophagus, or gastro-esophageal junction from 32 centers. To assess selection criteria and prognostic factors, a state arrival extended Markov proportional hazards (PH) model was used. RESULTS: 1792 subjects were analyzed, 5% of whom (n = 92) underwent surgery for metastasis. The most common surgeries were peritoneal (29%), hepatic (24%), and distant lymph nodes (11%). Subjects chosen for metastasectomy had higher survival rates, HR 0.34 (95% CI, 0.06-0.80, p = 0.021). Patients who underwent surgery had a mOS since metastasectomy of 16.7 months (95% CI, 12.5-22.4). The 1- and 3-year relapse rates following R0 resection were 58% and 65%, respectively. Median time since R0 metastasectomy until relapse was 8.4 months (95% CI, 7.6-23.7). The 3-year OS after surgery was 30.6% (95% CI, 19.3-40.4). Duration of chemotherapy prior to surgery (months) increased mortality (HR 1.04 [95% CI, 1.01-1.07]), p = 0.009. The only significant interaction involved the use of anti-HER2 therapy. CONCLUSION: The AGAMENON registry suggests that subjects with limited metastatic disease, selected on a clinical basis, can benefit from early surgeries. Prospective trials are needed to confirm these data.
Authors: Sena Valcarcel; Javier Gallego; Paula Jimenez-Fonseca; Marc Diez; Eva Martínez de Castro; Raquel Hernandez; Virginia Arrazubi; Ana Custodio; Juana María Cano; Ana Fernández Montes; Ismael Macias; Laura Visa; Aitana Calvo; Rosario Vidal Tocino; Nieves Martínez Lago; María Luisa Limón; Mónica Granja; Mireia Gil; Paola Pimentel; Lola Macia-Rivas; Carolina Hernández Pérez; Montserrat Mangas; Alfonso Martín Carnicero; Paula Cerdà; Lucía Gomez Gonzalez; Francisco Garcia Navalon; Mª Dolores Mediano Rambla; Marta Martin Richard; Alberto Carmona-Bayonas Journal: J Cancer Res Clin Oncol Date: 2022-08-30 Impact factor: 4.322
Authors: J Gallego Plazas; A Arias-Martinez; A Lecumberri; E Martínez de Castro; A Custodio; J M Cano; R Hernandez; A F Montes; I Macias; A Pieras-Lopez; M Diez; L Visa; R V Tocino; N Martínez Lago; M L Limón; M Gil; P Pimentel; M Mangas; M Granja; A M Carnicero; C Hernández Pérez; L G Gonzalez; P Jimenez-Fonseca; A Carmona-Bayonas Journal: ESMO Open Date: 2022-06-14
Authors: Marcus Fernando Kodama Pertille Ramos; Marina Alessandra Pereira; André Roncon Dias; Tiago Biachi de Castria; Erica Sakamoto; Ulysses Ribeiro-Jr; Bruno Zilberstein; Sérgio Carlos Nahas Journal: Arq Bras Cir Dig Date: 2022-06-17
Authors: A Viúdez; A Carmona-Bayonas; J Gallego; A Lacalle; R Hernández; J M Cano; I Macías; A Custodio; E Martínez de Castro; A Sánchez; L Iglesia; P Reguera; L Visa; A Azkarate; M Sánchez-Cánovas; M Mangas; M L Limón; A Martínez-Torrón; E Asensio; A Ramchandani; A Martín-Carnicero; A Hurtado; P Cerdà; M Garrido; R Sánchez-Bayonas; R Serrano; P Jiménez-Fonseca Journal: Clin Transl Oncol Date: 2019-08-05 Impact factor: 3.405
Authors: Almudena Cotes Sanchís; Javier Gallego; Raquel Hernandez; Virginia Arrazubi; Ana Custodio; Juana María Cano; Gema Aguado; Ismael Macias; Carlos Lopez; Flora López; Laura Visa; Marcelo Garrido; Nieves Martínez Lago; Ana Fernández Montes; María Luisa Limón; Aitor Azkárate; Paola Pimentel; Pablo Reguera; Avinash Ramchandani; Juan Diego Cacho; Alfonso Martín Carnicero; Mónica Granja; Marta Martín Richard; Carolina Hernández Pérez; Alicia Hurtado; Olbia Serra; Elvira Buxo; Rosario Vidal Tocino; Paula Jimenez-Fonseca; Alberto Carmona-Bayonas Journal: PLoS One Date: 2020-07-31 Impact factor: 3.240