634P - Prognostic evaluation of a multicenter cohort of 484 patients with metastatic gastroesophageal adenocarcinoma

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Oesophageal Cancer
Gastric Cancer
Presenter Maria Angeles Vicente Conesa
Citation Annals of Oncology (2014) 25 (suppl_4): iv210-iv253. 10.1093/annonc/mdu334
Authors M.A. Vicente Conesa1, L. Faez Garcia2, M. Garrido3, A. Custodio4, C. López5, L. Visa6, J. Gallego Plazas7, S. Fernandez Arrojo8, A. Ramchandani9, C. Murias10, V. Iranzo11, M. Múgica12, C. Giraldo13, N. Hindi14, F. Erpel13, E. Pineda6, E. Buxo6, E. Jofré13, P. Jimenez Fonseca15, A. Carmona-Bayonas1
  • 1Medical Oncology/hematology, Hospital Universitario Morales Meseguer, 30008 - Murcia/ES
  • 2Medical Oncology, Hospital Universitario Central de Asturias, oviedo/ES
  • 3Hemato-oncología, Centro Del Cáncer, Universidad Catolica de Chile, santiago d e chile/CL
  • 4Medical Oncology, Hospital Universitario La Paz, 29034 - Madrid/ES
  • 5Medical Oncology, Hospital Marqués de Valdecilla, Santander/ES
  • 6Department Medical Oncology, Hospital Clinic Barcelona, 08036 - Barcelona/ES
  • 7Medical Oncology, Hospital Universitario de Elche, 03202 - Elche/ES
  • 8Medical Oncology, Hospital Universitario Central de Asturias., oviedo/ES
  • 9Medical Oncology, Hospital de Las Palmas, Las Palmas/ES
  • 10Medical Oncology, Hospital Universitario de Canarias., tenerife/ES
  • 11Medical Oncology, Hospital General Universitario de Valencia, valencia/ES
  • 12Medical Oncology, Hospital Universitario Marqués de Valdecilla, santander/ES
  • 13Medical Oncology/hematology, Pontificia Universidad Católica de Chile., santiago de chile/CL
  • 14Oncología Médica, Hospital Universitario La Paz, madrid/ES
  • 15Servicio De Oncologia Medica, Hospital Universitario Central de Asturias, ES-33006 - Oviedo/ES

Abstract

Aim

To analyze the prognostic factors in patients with metastatic gastroesophageal adenocarcinoma treated with first-line chemotherapy.

Methods

A retrospective analysis was carried out on 484 patients who received first-line combined chemotherapy from 2004 to 2013. We used the multivariate Cox proportional hazards regression with bootstrap resampling to identify prognostic factors for overall survival (OS).

Results

356 (75%) patients have died with a median progression-free survival (PFS) and OS of: 6.2 (95%CI, 5.6-6.7) and 10.7 (95%CI, 9.4-12.1) months, respectively. Eight independent prognostic factors were identified in the multivariate analysis: two or more chronic comorbidities (hazard ratio [HR] 1.19; 95%CI, 1.04-1.36), European Cooperative Oncology Group (ECOG) performance status ≥2 (HR 1.40; 95%CI, 0.99-2.14), presence of signet ring cells (HR, 1.37; 95% CI, 1.07-1.72), Her2-overexpressing tumors treated with trastuzumab (HR, 0.71; 95% CI, 0.50-0.96), two or more sites of metastatic disease (HR 1.26; 95%CI, 1.08-1.63), carcinoembryonic antigen (CEA) ≥20 ng/ml (HR, 1.32; 95% CI, 1.23-1.69), presence of bone metastasis (HR, 1.99; 95% CI, 1.37-2.87) and ascitis (HR, 1.67; 95% CI, 1.26-2.21). We integrated these variables into a prognostic index with patients classified as low (n = 84), moderate (n = 324) and poor (n = 42) risk categories, with median OS: 13.9, 8.9 and 6.2 months, respectively (p < 0.001).

Conclusions

We have identified eight prognostic factors that could stratify patients and individualize therapeutic strategies in metastatic gastroesophageal adenocarcinoma setting.

Disclosure

All authors have declared no conflicts of interest.