Is advanced esophageal adenocarcinoma a distinct entity from intestinal subtype gastric cancer? Data from the AGAMENON-SEOM Registry
Por:
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
Publicada:
1 jul 2021
Ahead of Print:
1 mar 2021
Resumen:
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.
Filiaciones:
Alvarez-Mancenido, F:
Hosp Univ Cent Asturias, Dept Pharm, Ave Roma S-N, Oviedo 33011, Spain
Jimenez-Fonseca, P:
Hosp Univ Cent Asturias, Dept Med Oncol, ISPA, Oviedo, Spain
Carmona-Bayonas, A:
Univ Murcia, Hosp Univ Morales Meseguer, Hematol & Med Oncol Dept, IMIB, Murcia, Spain
Arrazubi, V:
Complejo Hosp Navarra, Dept Med Oncol, Pamplona, Spain
Hernandez, R:
Hosp Univ Canarias, Dept Med Oncol, Tenerife, Spain
Cano, JM:
Hosp Gen Univ Ciudad Real, Dept Med Oncol, Ciudad Real, Spain
Custodio, A:
Hosp Univ La Paz, Dept Med Oncol, CIBERONC CB16 12 00398, Madrid, Spain
Pijaume, CP:
Hosp Univ Parc Tauli, Dept Med Oncol, Sabadell, Spain
Aguado, G:
Hosp Univ Gregorio Maranon, Dept Med Oncol, Madrid, Spain
Lago, NM:
Complejo Hosp Univ A Coruna, Dept Med Oncol, La Coruna, Spain
Canovas, MS:
Hosp Univ Morales Meseguer, Hematol & Med Oncol Dept, Murcia, Spain
Lavin, DC:
Hosp Univ Marques de Valdecilla, Dept Med Oncol, IDIVAL, Santander, Spain
Visa, L:
Hosp Univ El Mar, Dept Med Oncol, Barcelona, Spain
Martinez-Torron, A:
Hosp Univ Marques de Valdecilla, Dept Pharm, Santander, Spain
Arias-Martinez, A:
Hosp Univ Cent Asturias, Dept Pharm, Ave Roma S-N, Oviedo 33011, Spain
Lopez, F:
Hosp Univ Doce Octubre, Dept Med Oncol, Madrid, Spain
Limon, ML:
Hosp Univ Virgen del Rocio, Dept Med Oncol, Seville, Spain
Tocino, RV:
Complejo Asistencial Univ Salamanca IBSAL, Dept Med Oncol, Salamanca, Spain
Montes, AF:
Complejo Hosp Orense, Dept Med Oncol, Orense, Spain
Alsina, M:
Hosp Univ Vall dHebron, Vall Hebron Inst Oncol VHIO, Dept Med Oncol, Barcelona, Spain
Pimentel, P:
Hosp Gen Univ Santa Lucia, Dept Med Oncol, Cartagena, Spain
Reguera, P:
Hosp Univ Ramon Y Cajal, Dept Med Oncol, Madrid, Spain
Carnicero, AM:
Hosp SanPedro, Dept Med Oncol, Logrono, Spain
Ramchandani, A:
Hosp Univ Insular Gran Canaria, Dept Med Oncol, Las Palmas Gran Canaria, Spain
Granja, M:
Hosp Univ Clin San Carlos, Dept Med Oncol, Madrid, Spain
Azkarate, A:
Hosp Univ Son Espases, Dept Med Oncol, Mallorca, Spain
Richard, MM:
Hosp Univ Santa Creu & St Pau, Dept Med Oncol, Barcelona, Spain
Serra, O:
Catalan Inst Oncol, Dept Med Oncol, Lhospitalet De Llobregat, Spain
Perez, CH:
Hosp Univ Nuestra Senora Candelaria, Dept Med Oncol, Tenerife, Spain
Hurtado, A:
Hosp Univ Fdn Alcorcon, Dept Med Oncol, Madrid, Spain
Gil-Negrete, A:
Hosp Univ Donostia, Dept Med Oncol, San Sebastian, Spain
Sauri, T:
Hosp Clin Barcelona, Dept Med Oncol, IDIBAPS, Barcelona, Spain
del Burgo, PM:
Hosp Univ Cent Asturias, Dept Pathol, Oviedo, Spain
Gallego, J:
Hosp Gen Univ Elche, Dept Med Oncol, Elche, Spain
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