A population-based study in synchronous versus metachronous metastatic esophagogastric adenocarcinoma

Therapeutic Advances in Medical Oncology, vol. 14, pp. 17588359221085557

Abstract

Background: Real-world data on treatment and outcomes in patients with synchronous metastatic disease compared with patients with metachronous metastatic disease in esophagogastric cancer have not been published before. The aim of our study was to explore treatment, overall survival (OS), and time to treatment fialure (TTF) in patients with synchronous and metachronous metastatic esophagogastric adenocarcinoma. Methods: Patients with synchronous metastatic disease (2015–2017) and patients with metachronous metastatic disease initially treated with curative intent for nonmetastatic disease (2015–2016) were selected from the Netherlands Cancer Registry. OS and TTF were assessed from metastatic diagnosis for patients with synchronous, early metachronous (⩽6 months) or late metachronous (>6 months) metastatic disease using Kaplan–Meier curves with two-sided log-rank test. Results: Median OS was 4.2, 2.1, and 4.4 months in patients with synchronous, early metachronous, and late metachronous metastatic disease, respectively ( p < 0.001). The proportion of patients receiving systemic treatment was 41.3%, 21.5%, and 32.5% for synchronous, early metachronous, and late metachronous metastatic disease, respectively ( p = 0.001). Among patients receiving systemic treatment, median OS was 8.8, 4.5, and 9.1 months ( p < 0.001) and median TTF was 6.1, 3.8, and 5.7 months ( p < 0.001) in synchronous, early metachronous, and late metachronous metastatic disease, respectively. Conclusion: Patients with early metachronous metastatic disease have a worse survival compared with patients with synchronous or late metachronous metastatic disease. These patients less often receive systemic treatment, and even when treated, survival is worse compared with patients with synchronous or late metachronous metastatic disease, suggesting a more aggressive tumor behavior.

Authors 12

1. Marieke Pape

   Netherlands Comprehensive Cancer Organisation · Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

   Affiliation as printed

   Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

   Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands

2. Pauline A. J. Vissers

   Radboud University Medical Center · Netherlands Comprehensive Cancer Organisation

   Affiliation as printed

   Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands

   Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands

3. David Bertwistle

   Bristol-Myers Squibb (United Kingdom)

   Affiliation as printed

   Worldwide Health Economics & Outcomes Research, Bristol-Myers Squibb, Uxbridge, UK

4. Laura McDonald

   Bristol-Myers Squibb (United Kingdom)

   Affiliation as printed

   Centre for Observational Research & Data Sciences, Bristol-Myers Squibb, Uxbridge, UK

5. Marije Slingerland Aachen Department of Medical Oncology

   Leiden University Medical Center

   Affiliation as printed

   Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands

6. Nadia Haj Mohammad

   Utrecht University · University Medical Center Utrecht

   Affiliation as printed

   Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

7. Laurens Victor Beerepoot

   Elisabeth-TweeSteden Ziekenhuis

   Affiliation as printed

   Department of Medical Oncology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands

8. Jelle P. H. Ruurda

   University Medical Center Utrecht

   Affiliation as printed

   Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands

9. Grard A. P. Nieuwenhuijzen

   Catharina Ziekenhuis

   Affiliation as printed

   Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands

10. Paul M. Jeene

    Radiotherapiegroep · Amsterdam University Medical Centers

    Affiliation as printed

    Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands

    Radiotherapiegroep, Deventer, The Netherlands

11. Hanneke W.M. van Laarhoven

    Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

    Affiliation as printed

    Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

12. Rob H.A. Verhoeven corresponding

    Netherlands Comprehensive Cancer Organisation · Amsterdam University Medical Centers · Cancer Center Amsterdam · University of Amsterdam

    Affiliation as printed

    Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands