Disease-free and overall survival in nonmetastatic esophageal or gastroesophageal junctional cancer after treatment with curative intent: A nationwide population-based study.

Authors

null

Marieke Pape

Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands

Marieke Pape , Pauline A.J. Vissers , Laurens Beerepoot , Mark I. Van Berge Henegouwen , Sjoerd Lagarde , Stella Mook , David Bertwistle , Laura McDonald , Hanneke W.M. Van Laarhoven , Rob Verhoeven

Organizations

Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands, Elisabeth TweeSteden Hospital, Tilburg, Netherlands, Department of Surgery, Amsterdam UMC, Amsterdam, Netherlands, EMC, Rotterdam, Netherlands, Utrecht UMC, Utrecht University, Department of Radiotherapy, Utrecht, Netherlands, Bristol-Myers Squibb Company, Princeton, NJ, Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, Netherlands, Netherlands Comprehensive Cancer Organisation, Eindhoven, Netherlands

Research Funding

Pharmaceutical/Biotech Company
Bristol Meyers Squibb

Background: Among patients with potentially curable esophageal cancer (EC) or gastroesophageal junctional cancer (GEJC) treated with curative intent, survival remains poor and around half of these patients have disease recurrence within a few years. This study addresses the need for real-world data on disease-free survival (DFS) and overall survival (OS) in patients with EC or GEJC who underwent potentially curative treatment. Methods: Patients selected from the nationwide Netherlands cancer registry (NCR) had received a primary diagnosis of non-metastatic EC or GEJC (excluding patients with T4b tumors) in 2015 or 2016 and received treatment with curative intent. Curative intent was defined as receiving resection (with or without [neo]adjuvant therapy) or definitive chemoradiotherapy (dCRT) without surgery. DFS and OS were analysed using Kaplan-Meier curves with Log-Rank test from resection date or end of dCRT. A sub-analysis was performed for NCR patients selected to align with the population of the CheckMate-577 phase 3 study of adjuvant nivolumab, i.e. patients with non-cervical stage II/III disease, R0 resection and residual pathological disease after neoadjuvant CRT (nCRT) and surgery. Results: We identified 1916 patients of median age of 67 years and predominantly male (76%). The majority (79%) received surgery and 21% of patients received dCRT. In resected patients, 83% received nCRT, 10% neoadjuvant chemotherapy (with or without adjuvant CRT) and 7% received no (neo)adjuvant treatment. Compared to the resected group, the population receiving dCRT had significantly fewer males (65% vs 78%), a higher median age (72 vs 65 years) and worse performance status. Patients receiving dCRT significantly shorter median DFS (14.2 months) and OS (20.9 months) compared to resected patients (DFS: 26.4 months, p < 0.001; OS: 40.5 months, p < 0.001). The 1- and 3-year DFS probabilities were 68% and 44%, respectively, in resected patients, and 56% and 24%, respectively, in patients receiving dCRT. In patients receiving nCRT followed by surgery, the median DFS and OS were 25.2 and 38.0 months, respectively, and 1- and 3-year DFS probabilities were 67% and 43%, respectively. In the sub-analysis (n = 725) the median DFS and OS were 19.2 and 29.4 months, respectively, and the 1- and 3-year DFS rates were 62% and 36%, respectively. Conclusions: Although patients are treated with curative intent, a considerable amount of patients with non-metastatic EC or GEJC experienced recurrence within two years. Resected patients had a higher DFS and OS compared to patients receiving dCRT.

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Abstract Details

Meeting

2021 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Esophageal and Gastric Cancer

Track

Esophageal and Gastric Cancer

Sub Track

Other

Citation

J Clin Oncol 39, 2021 (suppl 3; abstr 246)

DOI

10.1200/JCO.2021.39.3_suppl.246

Abstract #

246

Poster Bd #

Online Only

Abstract Disclosures