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

2021; Springer Science+Business Media; Volume: 24; Issue: 4 Linguagem: Inglês

10.1007/s10120-021-01169-6

1436-3305

Felipe Alvarez-Manceñido, Paula Jiménez‐Fonseca, Alberto Carmona‐Bayonas, Virginia Arrazubi, Raquel Hernández, Juana María Cano, Ana Custodio, Carles Pericay Pijaume, Gema Aguado, Nieves Martínez Lago, Manuel Sánchez Cánovas, Diego Cacho Lavín, Laura Visa, Alba Martínez-Torrón, Aránzazu Arias‐Martínez, Flora López López, María Luisa Limón, R. Vidal Tocino, Ana Fernández Montés, María Alsina, Paola Pimentel, Pablo Reguera, Alfonso Martín Carnicero, Avinash Ramchandani, Mónica Granja, Aitor Azkárate, Marta Martín Richard, Òlbia Serra, Carolina Hernández Pérez, Alicia Hurtado, A. Gil-Negrete, Tamara Saurí, Patricia Morales del Burgo, Javier Gállego,

Esophageal Cancer Research and Treatment

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. 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. 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). Our study supports the hypothesis that EAC exhibits clinicopathological characteristics, prognostic factors, and treatment outcomes comparable to intestinal GEJ-AC and GAC.