Abstract 1236P
Background
Known factors that might contribute to the dismal prognosis of gastroesophageal cancer are scarce. Comorbidities pose a potential prognostic factor, yet patients with severe diseases are often excluded from clinical trials, and, thus, data from real-life cohorts is warranted.
Methods
We analyzed comorbidities at the time of first cancer diagnosis and their association with overall survival (OS) in patients with gastroesophageal cancer, who were treated at the Medical University of Vienna between 1990 and 2020. Survival analyses were performed with log-rank and Cox regression analyses as appropriate.
Results
We analyzed 1574 patients (70% male, mean age 63 (SD 11.8)) with gastroesophageal cancer (13% stage I, 21% stage II, 31% stage III, 36% stage IV; 30% GEJ, 40% stomach, 30% esophagus; 79% adenocarcinoma). 79% of patients were already dead at the time of this analysis. Concerning patient characteristics, only stage (p≤0.001) and age (p≤0.001) were statistically significantly associated with the OS. Comorbidities and their association with the OS are shown in the Table. There were 147 patients (9%) without any recorded comorbidity, 310 (20%) with one, 376 (24%) with 2, 313 (20%) with 3, 230 (14%) with 4, 119 (8%) with 5, 61 (4%) with 6 diseases, 18 (1%) with 7or more comorbidities. Number of comorbidities was not associated with OS (p=0.228). In a multivariate analysis, including all variables which were statistically significant in univariate analyses, lung disease (p=0.002, HR=1.259 (1.091-1.453)), age (p≤0.001, HR=1.012 (1.007-1.018)) and stage (p≤0.001, HR=1.829 (1.717-1.948)) were statistically significantly associated with the OS. Table: 1236P
Comorbidities and their association with the OS
| Comorbidity | n (%) | OS in months (95% CI) without vs with comorbidity | p |
| Kidney | 183 (12%) | 21.3 (19.5-23.1) vs 15.8 (11.1-20.5) | 0.003 |
| Diabetic | 217 (14%) | 20.8 (19.2-22.4) vs 22.2 (16.8-27.6) | 0.954 |
| Lung | 290 (18%) | 21.4 (19.6-23.2) vs 16.9 (14.1-19.7) | 0.001 |
| Liver | 357 (23%) | 20.5 (18.8-22.2) vs 22.0 (17.6-26.4) | 0.381 |
| Orthopedic | 361 (23%) | 21.2 (19.3-23.1) vs 19.3 (16.7-21.9) | 0.492 |
| Infectious | 369 (23%) | 21.0 (19.2-22.8) vs 20.4 (17.2-23.6) | 0.759 |
| Gastrointestinal | 526 (33%) | 20.9 (19.0-22.8) vs 21.0 (17.3-24.7) | 0.793 |
| Cardiovascular | 822 (52%) | 21.5 (19.3-23.7) vs 19.4 (17.3-21.5) | 0.017 |
| Other | 886 (56%) | 21.2 (18.4-24.0) vs 20.7 (18.7-22.7) | 0.048 |
Conclusions
Comorbidities might play an important role concerning prognosis in gastroesophageal cancer patients. Prospective studies to evaluate large real-life cohorts are warranted to improve patient management in everyday clinical routine.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Aysegül Ilhan-Mutlu.
Funding
Has not received any funding.
Disclosure
H.C. Puhr: Other, Institutional, Other: HC.P. has received travel support from Eli Lilly, MSD, Novartis, Pfizer and Roche and received lecture honoraria from Eli Lilly.. A.S.S. Berghoff: Other, 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 an. M. Preusser: Other, Institutional, Other: MP 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 Journal. A. Ilhan-Mutlu: Other, Institutional, Other: A.I-M. participated in advisory boards from MSD, BMS and Servier, received lecture and consultation honoraria from Eli Lilly, MSD, Servier and Astellas, is the local PI for clinical trials sponsored by BMS, Roche and Amgen and received travel support from. All other authors have declared no conflicts of interest.