Abstract 1400P
Background
Gastroesophageal adenocarcinoma is a devastating disease with poor overall survival (OS) even in resectable stages. Patients often suffer from symptoms such as dysphagia, weight loss, dyspepsia and gastrointestinal bleeding, which reduce the quality of life immensely. However, there exists little knowledge of the association of these initial symptoms with the OS in large European cohorts. The aim of this analysis was to investigate these factors more thoroughly to improve future patient management.
Methods
We evaluated initial symptoms and their association with the outcome in patients with stage II-III gastroesophageal adenocarcinoma treated at the Medical University of Vienna between 1990 and 2020.
Results
In total, the survival outcome of 646 patients (36% stage II, 62% stage III, 2% stage II-III) was evaluated, of which 493 (76%) patients had already died at the time of this analysis. Half of the cohort (322 pts, 50%) reported dysphagia as a main symptom at first diagnosis, 284 (44%) patients complained of weight loss, 67 patients (10%) of major weakness and 379 (59%) of dyspepsia. In initial endoscopies 202 (31%) had stenosis, 53 (8%) ulceration and 72 (11%) actively bleeding tumors. Dysphagia (median OS: no (n=209) 2.6 (95% CI 1.8-3.4) vs yes (n=322) 2.0 (95% CI 1.6-2.3) years; p=0.012), weight loss (median OS: no (n=236) 2.6 (95% CI 2.0-3.3) vs yes (n=284) 1.7 years (95% CI 1.4-2.0); p=0.009) and stenosis in endoscopy (median OS: no (n=310) 2.6 (95% CI 1.9-3.3) vs yes (n=202) 1.8 (95% CI 1.5-2.1) years; p<0.001) were significantly associated with the outcome. There was no statistically significant association of weakness, gastrointestinal bleeding, dyspepsia or body mass index with the OS.
Conclusions
The results of this analysis of a large European cohort suggest that dysphagia and weight loss as well as stenosis in endoscopy might be prognostic markers even in resectable stages. Thus, this study is an important impulse for further prospective evaluation of these markers in this patient cohort and might lead to more awareness concerning symptoms and supportive therapeutic strategies such as nutrition counselling.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H.C. Puhr: Other, Personal and Institutional, Other, HC.P. has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche: HC.P. has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche. A.S. Berghoff: Other, Personal and Institutional, Other, AS.B. has received research support from Daiichi Sankyo and Roche, honoraria for lectures, consultation or advisory board participation from Roche, Bristol-Meyers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen, Daiichi Sankyo and AbbVie: AS.B. has received research support from Daiichi Sankyo and Roche, honoraria for lectures, consultation or advisory board participation from Roche, Bristol-Meyers Squibb, Merck, Daiichi Sankyo as well as travel support from Roche, Amgen, Daiichi Sankyo an. M. Preusser: Other, Personal and Institutional, Other, M.P. has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen. The following for-profit companies have supported clinical trials and contracted research conducted by M.P. with payments made to his institution: Böhringer-Ingelheim, Bristol-Myers Squibb, Roche, Daiichi Sankyo, Merck Sharp & Dome, Novocure, GlaxoSmithKline, AbbVie.: M.P. has received honoraria for lectures, consultation or advisory board participation from the following for-profit companies: Bayer, Bristol-Myers Squibb, Novartis, Gerson Lehrman Group (GLG), CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journ. A. Ilhan-Mutlu: Financial Interests, Personal and Institutional, Other: A.I-M. participated in advisory boards of MSD, BMS and Servier, received lecture honoraria from Eli Lilly, MSD, BMS and Servier, is the local PI for clinical trials sponsored by BMS and Roche and received travel support from BMS, Daiichi Sankyo, Eli Lilly. All other authors have declared no conflicts of interest.