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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Published inGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 24; no. 4; pp. 926 - 936
Main Authors Alvarez-Manceñido, Felipe, Jimenez-Fonseca, Paula, Carmona-Bayonas, Alberto, Arrazubi, Virginia, Hernandez, Raquel, Cano, Juana M., Custodio, Ana, Pericay Pijaume, Carles, Aguado, Gema, Martínez Lago, Nieves, Sánchez Cánovas, Manuel, Cacho Lavin, Diego, Visa, Laura, Martinez-Torron, Alba, Arias-Martinez, Aranzazu, López, Flora, Limón, M. Luisa, Vidal Tocino, Rosario, Fernández Montes, Ana, Alsina, Maria, Pimentel, Paola, Reguera, Pablo, Martín Carnicero, Alfonso, Ramchandani, Avinash, Granja, Mónica, Azkarate, Aitor, Martín Richard, Marta, Serra, Olbia, Hernández Pérez, Carolina, Hurtado, Alicia, Gil-Negrete, Aitziber, Sauri, Tamara, Morales del Burgo, Patricia, Gallego, Javier
Format Journal Article
LanguageEnglish
Published Singapore Springer Singapore 01.07.2021
Springer Nature B.V
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ISSN1436-3291
1436-3305
1436-3305
DOI10.1007/s10120-021-01169-6

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Summary: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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ISSN:1436-3291
1436-3305
1436-3305
DOI:10.1007/s10120-021-01169-6