Abstract 1463P
Background
Perioperative chemotherapy is a standard treatment for operable oesophagogastric cancer. It is still unclear to what extent weight loss is relevant for this population’s prognosis. The aim of this study is to analyze the prognostic effects of weight loss at different timepoints during perioperative chemotherapy for locally advanced GC and GEJ adenocarcinomas.
Methods
We retrospectively analyzed data for 128 patients diagnosed with GC and GEJ adenocarcinoma who underwent surgery in the context of a multimodal treatment with perioperative chemotherapy. We collected data on weight and weight loss during different steps of the perioperative therapy (neoadjuvant part, operative part, adjuvant part, whole treatment) together with other histopathologic, demographic and other prognostically relevant information. We then analyzed the effects on overall survival (OS) and disease-free survival (DFS).
Results
Patients with weight loss ≥ 5% during neoadjuvant chemotherapy had significantly worse OS (23.6 months [95%-CI: 4.4 – 42.9] vs. 63.5 months [95%-CI: 50.7 – 76.2], p=0.007) and DFS (12.5 months [95%-CI: 2.9 – 22.1] vs. 63.5 months [95%-CI: 31.6 – 95.4], p=0.016) compared to patients with weight loss < 5% or weight gain. Patients with a weight loss ≥ 14% during the whole treatment also had significantly worse OS (43.7 months [95%-CI: 13.2 - 74.2] vs. not reached, p=0.028) and DFS (34.3 months, [95%-CI: 14.0 - 54.5] vs. not reached, p=0.038) compared to patients with weight loss < 14% in the same time frame. No relationships were found between weight loss and other variables like histopathological regression status or the administration of adjuvant chemotherapy, supporting the assumption of an independent effect of weight loss on prognosis.
Conclusions
Weight loss during neoadjuvant chemotherapy and weight loss during the whole treatment correlate with a significantly worse prognosis in operated patients with locally advanced operable oesophagogastric cancer in the context of a multimodal treatment with perioperative chemotherapy. A validation of this prognostic effect in prospective studies is warranted.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.