Is advanced esophageal adenocarcinoma a distinct entity from intestinal subtype gastric cancer? Data from the AGAMENON-SEOM Registry

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 advance...

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Detalhes bibliográficos
Autores: Alvarez-Mancenido, F, Jimenez-Fonseca, P, Carmona-Bayonas, A, Arrazubi, V, Hernandez, R, Cano, JM, Custodio, A, Pijaume, CP, Aguado, G, Lago, NM, Canovas, MS, Lavin, DC, Visa, L, Martinez-Torron, A, Arias-Martinez, A, Lopez, F, Limon, ML, Tocino, RV, Montes, AF, Alsina, M, Pimentel, P, Reguera, P, Carnicero, AM, Ramchandani, A, Granja, M, Azkarate, A, Richard, MM, Serra, O, Perez, CH, Hurtado, A, Gil-Negrete, A, Sauri, T, del Burgo, PM, Gallego, J
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2021
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositório:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p11795
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/11795
Access Level:Acceso aberto
Palavra-chave:Esophageal adenocarcinoma
Chemotherapy
Gastric cancer
Gastroesophageal junction
Trastuzumab
Survival
Prognosis
Advanced cancer
Lauren type
Erbb
Descrição
Resumo: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.

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