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Background Methods Results Conclusion References Survival outcomes among patients (pt) with Locally Advanced Esophageal Cancer (LAEC) treated within a multidisciplinary Gastro-Esophageal cancer Functional Unit (UFEG) Plaja A1, Ferrando A1, Bugés C1, Hierro C1, Caro M2, Viciano M3, España S1, García O4, Barluenga E5, Colan JA6, Lopez R7, Sendra M8, Alvaro M9, Joaquin C10, Riquelme M11, Hernandez A12, Calderon N12, Lopez A13, Jose M14, Layos L1, Manzano JL1, Font A1 1Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain 8Anestesiology Department, Germans Trias i Pujol University Hospital (HUGTiP), Badalona, Barcelona, Spain 2Radiation Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain 9Palliative Care Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain 3Surgery Depatment, Germans Trias i Pujol University Hospital (HUGTiP), Badalona, Barcelona, Spain 10Endocrinology Department, Germans Trias i Pujol University Hospital (HUGTiP), Badalona, Barcelona, Spain 4Statistics Department, Cataln Institute of Oncology (ICO)-Badalona, Badalona, Barcelona, Spain 11Social Worker Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain 5Radiodiagnostic Department, Germans Trias i Pujol University Hospital (HUGTiP), Badalona, Barcelona, Spain 12Advanced Practice Nursing Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain 6Gastroenterology Department, Germans Trias i Pujol University Hospital (HUGTiP), Badalona, Barcelona, Spain 13Auxiliary of Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain 7Pathology Department, Germans Trias i Pujol University Hospital (HUGTiP), Badalona, Barcelona, Spain 14Administrative of Oncology Department, Catalan Institute of Oncology (ICO)-Badalona, Barcelona, Spain BACKGROUND METHODS Management of LAEC is challenging since its aggressive behavior, often From 2012 to 2018, 150 newly diagnosed esophageal cancers diagnosed in pt with significant comorbidities. A multimodal approach could were referred to our UFEG, of whom 90 were LAEC. Several enhance treatment results and quality of life. We aimed to assess outcome UFEG specialists at this first consultation evaluated every case, differences in a non-clinical trial scenario in our LAEC cohort, according to a in order to establish a multimodal therapeutic plan. All multidisciplinary management in a highly specialized UFEG integrated by demographic, treatment and survival data were extracted different specialists. retrospectively from available electronic medical records. RESULTS Median age was 65 years (range 30 – 90), with 24% pt ≥ 75 years and 83% men. 68% Table 1. Baseline dCRT nCRT were squamous carcinomas and 32% adenocarcinomas. characteristics N=42 (%) N=31 (%) 81% pt were eligible for radical treatment, whilst 7% received palliative chemotherapy Median age (years) 70 61 (CHT) and 12% were deemed candidates only for best supportive care, mostly due to > 75 years 13 (31) 1 (3) poor performance status ≥ 2. Squamous carcinoma 30 (71) 18 (58) Focusing on pt that underwent curative treatments: Inferior esophageal 22 (52) 23 (74) • 58% received definitive chemo-radiotherapy (dCRT) and 42% pt received neoadjuvant TNM 5 (12) 8 (26) chemo-radiotherapy (nCRT), followed by surgery in 94% of the cases. Baseline T2N+M0 20 (48) 21 (68) characteristics are shown in table 1. T3N+M0 17 (40) 2 (6) • 59% achieved a pathological downstaging, including 24% (n=7) pt with a complete T4N+M0 pathological response (pCR). CHT regime 20 (48) 24 (77) Cisplatin-5FU Figure 1. mOS in nCRT and dCRT 22 (52) 5 (16) Carboplatin-taxol • The 3-year median overall survival (mOS) Surgery 29 (94) was 29% in the nCRT group and 27% in the Pathological downstaging - 17 (59) dCRT group. Figure 1 Complete pathological response 7 (24) Surgical complications - 9 (31) • The recurrence rate was higher in the dCRT (52%) compared to nCRT (32%). Distant Surgical in-hospital mortality - 2 (7) relapses were more frequent than local- Recurrence 22 (52) 10 (32) regional ones (79% vs. 21%). Distance relapse 16 (73) 9 (90) Loco-regional 6 (27) 1 (10) CONCLUSION REFERENCES 1. Herskovic A, et al. Esophageal carcinoma advances in In our LAEC cohort, 3-year mOS was similar in dCRT and nCRT groups. However, pt that treatment results for locally advanced disease: review. Ann underwent nCRT followed by surgery had lower recurrences, achieving similar pCR to those Oncol. (2012). 2. Al-Sarraf M, et al. Progress report of combined reported in the literature. chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer: an intergroup study. J Clin 24% pt were ≥ 75 years, which prompted us to implement a geriatric assessment among all Oncol(1997). elderly pt. Multidisciplinary management at a UFEG ensures that LAEC pt receive optimized 3. Van Hagen P, et al. Preoperative chemoradiotherapy for world-class care, and seems warranted to further improve the outcomes of these pt. esophageal or junctional cancer. N Engl J Med (2012). P-317 Clinical Esophageal Cancer Poster WCGIC WCGIC presented at: 22 Andrea Plaja Salarich.
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