Comparison of survival between de novo stage IV and recurrent stage IV gastric cancer.

Authors

null

Jun Ho Ji

Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea;

Jun Ho Ji , Danbi Lee , Yong-Pyo Lee , Seok Jae Huh , Se-Il Go , Jung Hoon Kim , Sung Yong Oh , Jung Hun Kang , Kwang Min Kim

Organizations

Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea; , Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; , Division of Hematology-Oncology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea; , Donga University Hospital, Busan, South Korea; , Gyeongsang National University Changwon Hospital, Changwon-Si, Gyeongsangnam-d, South Korea; , Division of Hematology/Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju-Si, South Korea; , Donga University Hospital, Seo-Gu, South Korea; , Gyeongsang University Hospital, Jinju-Si, South Korea; , Division of Gastroenterology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea;

Research Funding

No funding received
None.

Background: The characteristics and prognosis of de novo metastatic gastric cancer and recurrent metastatic gastric cancer have not yet been elucidated. Here, we compare prognosis and characteristics of patients with de novo versus recurrent gastric cancer. Methods: This retrospective study included 301 advanced pathologically confirmed gastric cancer patients who received palliative chemotherapy between 2012 and 2022. The de novo cohort was included of patients who presented with distant metastasis at diagnosis and recurrent metastatic cohort was composed of patients with metastasis after curative gastrectomy. We analyzed prognostic association by Cox regression and compared survival time of both cohorts using the Kaplan-meire method. Results: A total of 167 de novo and 112 recurrent patients were included. There were no differences noted among the patients with de novo disease and recurrent metastatic disease with respect to age, sex, ECOG, primary cancer location and pathologic features. Patients in the recurrent group versus de novo group were longer duration of chemotherapy (1.16 ± 1.18 years versus 0.85 ± 0.84, P = 0.01) and lower mean body mass index. (20.22 ± 2.78 versus 21.93 ± 3.38, p < 0.001) The median overall survival in the de novo group was 11.6 versus s 14.4 months in the recurrent group. (P = 0.02) In a multivariate analysis, the age of 70 years or older at the time of stage 4 diagnosis was independently associated with shorter survival. Conclusions: De novo and recurrent metastatic gastric cancer characterize distinguished subpopulations. And advanced gastric cancer with distant recurrence has significantly better survival versus those with de novo cohort. This differences between de novo and recurrent gastric cancer could facilitate discussions about patient selection of clinical trial and help with advanced personalized treatment.

Baseline Characteristics De novo (n=167)Recurrent (n=112)P-value
> 70 years79 (47.31)47 (41.96)
Gender0.173
Female44 (26.35)38 (33.93)
Male123 (73.65)74 (66.07)
ECOG (n=278)0.382
0-2161 (96.41)109 (98.20)
Others6 (3.59)2 (1.80)
Duration for chemotherapy0.85 ± 0.841.16 ± 1.180.010
BMI (n=276)21.93 ± 3.3820.22 ± 2.78<0.001
< 18.522 (13.17)29 (26.61)<0.001
18.5-25.0109 (65.27)75 (68.81)
≥ 25.036 (21.56)5 (4.59)
Smoking (n=244)0.029
Never61 (41.78)51 (52.04)
Ex41 (28.08)32 (32.65)
Current44 (30.14)15 (15.31)
Primary site (n=277)0.282
Antrum69 (41.57)39 (35.14)
Others97 (58.43)72 (64.86)
Operation (n=98)-
Subtotal-55 (56.12)
Total-43 (43.88)
HER2 status (n=278)0.396
Positive24 (14.46)13 (11.61)
Negative135 (81.33)97 (86.61)
Unknown7 (4.22)2 (1.79)
Degree of differentiation0.327
Well9 (5.39)9 (8.04)
Moderate51 (30.54)31 (27.68)
Poor88 (52.69)52 (46.43)
Others19 (11.38)20 (17.86)
Tissue organization (n=278)0.155
Adenoca140 (84.34)84 (75.00)
PCC16 (9.64)17 (15.18)
Others10 (6.02)11 (9.82)

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Abstract Details

Meeting

2023 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach and Other GI Cancers

Track

Esophageal and Gastric Cancer,Other GI Cancer

Sub Track

Patient-Reported Outcomes and Real-World Evidence

Citation

J Clin Oncol 41, 2023 (suppl 4; abstr 304)

DOI

10.1200/JCO.2023.41.4_suppl.304

Abstract #

304

Poster Bd #

C3

Abstract Disclosures