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Impact of primary tumour resection on survival and chemotherapy tolerance in patients with metastatic oesophagogastric cancer undergoing palliative chemotherapy

Date

08 Oct 2016

Session

Poster Display

Presenters

Sebastian Ochenduszko

Citation

Annals of Oncology (2016) 27 (6): 207-242. 10.1093/annonc/mdw371

Authors

S. Ochenduszko1, M. Puskulluoglu2, K. Konopka1, A. Michalowska-Kaczmarczyk1, K. Fijorek3, M. Pedziwiatr4, A. Budzynski4

Author affiliations

  • 1 Department Of Oncology, University Hospital in Krakow, 31-531 - Krakow/PL
  • 2 Department Of Oncology, Jagiellonian University Medical College, 31-531 - Krakow/PL
  • 3 Department Of Statistics, Krakow University of Economics, Krakow/PL
  • 4 2nd Department Of General Surgery, Jagiellonian University Medical College, 31-501 - Krakow/PL
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Background

The role of primary tumour resection in patients with metastatic oesophagogastric adenocarcinoma (mOGA) undergoing palliative chemotherapy (CTH) is the subject of an intense debate. We decided to analyse retrospectively the impact of primary tumour resection on survival and CTH tolerance in patients with mOGA undergoing palliative CTH.

Methods

Patients with mOGA who started palliative CTH between January 2010 and May 2015 were identified from the electronic database of the Department of Oncology at the University Hospital in Krakow. We performed a charts review to obtain baseline demographics, performance status, laboratory parameters, dates of progression, death and last follow-up. Patients were divided into two groups: A-primary tumour resected, B-primary tumour present. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method.

Results

One hundred sixty-five patients were identified: group A n = 89, group B n = 76. No significant differences in baseline characteristics were observed. Median OS was 10.5 months (95% CI 8.5-13.5) in group A vs 8.4 months (6.0-10.5) in group B (log-rank p = 0.013). Median PFS was 6.4 months (4.8-7.5) and 5.1 months (4.1-6), respectively (log-rank p = 0.019). There were no statistically significant differences in grade 3 or 4 chemotherapy-related adverse events between groups: anaemia (gr. A 5.8% vs gr. B 9.7%), leukopenia (11.6% vs 15.3%), neutropenia (47.7% vs 43.1%), febrile neutropenia (4.7% vs 5.6%), thrombocytopenia (1.2% vs 0.0%), nausea (1.2% vs 1.4%), vomiting (2.3% vs 1.4%), diarrhoea (5.8% vs 1.4%), anorexia (3.5% vs 4.2%), fatigue (3.5% vs 4.2%), mucositis (1.2% vs 1.4%), hand-foot syndrome (1.2% vs 0.0%), peripheral neuropathy (1.2% vs 0.0%). No statistically significant differences were observed for CTH cycle delays (gr. A 71.6% vs gr. B 68.5%; p = 0.799) and CTH dose reductions (gr. A 28.4% vs gr. B 20.3%; p = 0.311).

Conclusions

In this retrospective analysis, primary tumour resection in patients with mOGA improved OS and did not influence the tolerance of palliative CTH. Updated data with a longer follow-up will be presented.

Clinical trial identification

Legal entity responsible for the study

Jagiellonian University Medical College, Krakow, Poland

Funding

Jagiellonian University Medical College, Krakow, Poland

Disclosure

All authors have declared no conflicts of interest.

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