Felipe Alvarez-Manceñido1, Paula Jimenez-Fonseca2, Alberto Carmona-Bayonas3, Virginia Arrazubi4, Raquel Hernandez5, Juana M Cano6, Ana Custodio7, Carles Pericay Pijaume8, Gema Aguado9, Nieves Martínez Lago10, Manuel Sánchez Cánovas11, Diego Cacho Lavin12, Laura Visa13, Alba Martinez-Torron14, Aranzazu Arias-Martinez15, Flora López16, M Luisa Limón17, Rosario Vidal Tocino18, Ana Fernández Montes19, Maria Alsina20, Paola Pimentel21, Pablo Reguera22, Alfonso Martín Carnicero23, Avinash Ramchandani24, Mónica Granja25, Aitor Azkarate26, Marta Martín Richard27, Olbia Serra28, Carolina Hernández Pérez29, Alicia Hurtado30, Aitziber Gil-Negrete31, Tamara Sauri32, Patricia Morales Del Burgo33, Javier Gallego34. 1. Pharmacy Department, Hospital Universitario Central de Asturias, Avenida Roma s/n, 33011, Oviedo, Spain. felipealvarezm@yahoo.es. 2. Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain. 3. Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, University of Murcia, IMIB, Murcia, Spain. 4. Medical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain. 5. Medical Oncology Department, Hospital Universitario de Canarias, Tenerife, Spain. 6. Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain. 7. Medical Oncology Department, Hospital Universitario La Paz, CIBERONC CB16/12/00398, Madrid, Spain. 8. Medical Oncology Department, Hospital Universitario Parc Tauli, Sabadell, Spain. 9. Medical Oncology Department, Hospital Universitario Gregorio Marañón, Madrid, Spain. 10. Medical Oncology Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain. 11. Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, Murcia, Spain. 12. Medical Oncology Department, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain. 13. Medical Oncology Department, Hospital Universitario El Mar, Barcelona, Spain. 14. Pharmacy Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 15. Pharmacy Department, Hospital Universitario Central de Asturias, Avenida Roma s/n, 33011, Oviedo, Spain. 16. Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain. 17. Medical Oncology Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain. 18. Medical Oncology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain. 19. Medical Oncology Department, Complejo Hospitalario de Orense, Orense, Spain. 20. Medical Oncology Department, Hospital Universitario Vall d'Hebron, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain. 21. Medical Oncology Department, Hospital General Universitario Santa Lucía, Cartagena, Spain. 22. Medical Oncology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. 23. Medical Oncology Department, Hospital San Pedro, Logroño, Spain. 24. Medical Oncology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. 25. Medical Oncology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain. 26. Medical Oncology Department, Hospital Universitario Son Espases, Mallorca, Spain. 27. Medical Oncology Department, Hospital Universitario Santa Creu i Sant Pau, Barcelona, Spain. 28. Medical Oncology Department, Catalan Institute of Oncology, L'Hospitalet, Spain. 29. Medical Oncology Department, Hospital Universitario Nuestra Señora de la Candelaria, Tenerife, Spain. 30. Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 31. Medical Oncology Department, Hospital Universitario Donostia, San Sebastián, Spain. 32. Medical Oncology Department, Hospital Clinic, IDIBAPS, Barcelona, Spain. 33. Pathology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 34. Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain.
Abstract
BACKGROUND: Advanced esophageal adenocarcinoma (EAC) is generally treated similarly to advanced gastroesophageal junction (GEJ-AC) and gastric (GAC) adenocarcinomas, although GAC clinical trials rarely include EAC. This work sought to compare clinical characteristics and treatment outcomes of advanced EAC with those of GEJ-AC and GAC and examine prognostic factors. PATIENTS AND METHODS: Participants comprised patients with advanced EAC, intestinal GEJ-AC, and GAC treated with platin and fluoropyrimidine (plus trastuzumab when HER2 status was positive). Overall and progression-free survival were estimated using the Kaplan-Meier method. Cox proportional hazards regression gauged the prognostic value of the AGAMENON model. RESULTS: Between 2008 and 2019, 971 participants from the AGAMENON-SEOM registry were recruited at 35 centers. The sample included 67.3% GAC, 13.3% GEJ-AC, and 19.4% EAC. Pulmonary metastases were most common in EAC and peritoneal metastases in GAC. Median PFS and OS were 7.7 (95% CI 7.3-8.0) and 13.9 months (12.9-14.7). There was no difference in PFS or OS between HER2- and HER2+ tumors from the three locations (p > 0.05). Five covariates were found to be prognostic for the entire sample: ECOG-PS, histological grade, number of metastatic sites, NLR, and HER2+ tumors treated with trastuzumab. In EAC, the same variables were prognostic except for grade. The favorable prognosis for HER2+ cancers treated with trastuzumab was homogenous for all three subgroups (p = 0.351) and, after adjusting for the remaining covariates, no evidence supported primary tumor localization as a prognostic factor (p = 0.331). CONCLUSION: Our study supports the hypothesis that EAC exhibits clinicopathological characteristics, prognostic factors, and treatment outcomes comparable to intestinal GEJ-AC and GAC.
BACKGROUND: Advanced esophageal adenocarcinoma (EAC) is generally treated similarly to advanced gastroesophageal junction (GEJ-AC) and gastric (GAC) adenocarcinomas, although GAC clinical trials rarely include EAC. This work sought to compare clinical characteristics and treatment outcomes of advanced EAC with those of GEJ-AC and GAC and examine prognostic factors. PATIENTS AND METHODS: Participants comprised patients with advanced EAC, intestinal GEJ-AC, and GAC treated with platin and fluoropyrimidine (plus trastuzumab when HER2 status was positive). Overall and progression-free survival were estimated using the Kaplan-Meier method. Cox proportional hazards regression gauged the prognostic value of the AGAMENON model. RESULTS: Between 2008 and 2019, 971 participants from the AGAMENON-SEOM registry were recruited at 35 centers. The sample included 67.3% GAC, 13.3% GEJ-AC, and 19.4% EAC. Pulmonary metastases were most common in EAC and peritoneal metastases in GAC. Median PFS and OS were 7.7 (95% CI 7.3-8.0) and 13.9 months (12.9-14.7). There was no difference in PFS or OS between HER2- and HER2+ tumors from the three locations (p > 0.05). Five covariates were found to be prognostic for the entire sample: ECOG-PS, histological grade, number of metastatic sites, NLR, and HER2+ tumors treated with trastuzumab. In EAC, the same variables were prognostic except for grade. The favorable prognosis for HER2+ cancers treated with trastuzumab was homogenous for all three subgroups (p = 0.351) and, after adjusting for the remaining covariates, no evidence supported primary tumor localization as a prognostic factor (p = 0.331). CONCLUSION: Our study supports the hypothesis that EAC exhibits clinicopathological characteristics, prognostic factors, and treatment outcomes comparable to intestinal GEJ-AC and GAC.
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