Abstract 479P
Background
Localized gastroesophageal carcinomas require a multidisciplinary approach. No surveillance protocols have been standardized and their impact on patient’s survival remains elusive. In this study, we aim to expose our experience in this setting.
Methods
We performed a retrospective analysis recruiting all patients diagnosed with gastroesophageal carcinomas treated with surgery in Ramon y Cajal University Hospital. Surveillance protocol consisted of biannual evaluation with tumoral marker CEA and CT scans for the first 3 years. Thereafter, annual visits were conducted for 10 years.
Results
Between 2014 and 2023, 199 patients with localized gastroesophageal tumours underwent surgical treatment. Regarding peri-operative treatment, pre and postoperative chemotherapy was applied in 58.3% and 54,3% respectively. Radiotherapy was used before surgery in 10% of patients and 10% received it after surgery. With a median follow-up of 49.9 months, median disease-free survival (DFS) and overall survival (OS) were not reached. DFS and OS rates at 5 years were 54.7% and 61.45%, respectively. Among 76 relapses, 63.2% were metastatic, 18.4% locoregional and 18.4% had both patterns of relapse. The prognostic factors associated with worse DFS (p<0.005) were primary tumour location, HER2-positive status and TNM stage. Relapses were detected at the planned surveillance in 57.9% of cases with a median OS of 46.6 months. On the other hand, 42.1% were found in unscheduled follow-up due to symptoms derived from the disease, with a median OS of 27.3 months (95%CI 16.8 – 35.9). This difference was statistically different (log-rank p=0.0021) with an HR of 2.37 (95%CI 1.34-4.17).
Conclusions
This study highlights the poorer prognosis of relapses detected in unscheduled follow-up and the potential role of planned surveillance improving survival outcomes. Prospective studies are warranted to design standardized surveillance protocols.
Legal entity responsible for the study
Hospital Universitario Ramon y Cajal; Instituto Ramon y Cajal de Investigación Sanitaria (IRYCIS).
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.