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Session: Therapy General ePoster Viewing [Return to Session]

Outcome of Unconventional Pattern of Treatment for Esophageal Cancer Patients

A Dey1, T Biswas2, T Podder2*, (1) University of Akron, Akron, OH, (2) University Hospitals Seidman Cancer Center, Cleveland, OH

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PO-GePV-T-85 (Sunday, 7/10/2022)   [Eastern Time (GMT-4)]

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Purpose: Neoadjuvant Chemo-RT (chemo-radiation followed by surgery) is the standard of care for managing advanced esophageal cancer. Next best option for these patients is Chemo-RT, if they are not surgical candidates. In this study we have investigated the overall survival (OS) when the patients were treated with Surgery only or Chemo-RT or RT only.

Methods: A total of 24,997 patients were found in National Cancer Database (NCDB) who were treated between 2004 and 2018, eligible for this study. We have included Stage-2 (n=11,080) and Stage-3 (n=13,917) patients who received surgery only (no RT, no chemotherapy) or Chemo-RT only (no surgery) and RT only (no chemotherapy, no surgery), which are uncommon pattern/modality of treating Stage 2-3 esophageal cancers. Primary clinical goal was the overall survival (OS) that was determined using Kaplan-Meier estimator. IBM SPSS (version 26.0) was used for statistical analysis; p-value less than 0.05 was considered statistically significant.

Results: Majority of the patients were treated with Chemo-RT (87.4%), followed by RT only (6.8%), rest with surgery only (5.9%). Number of patients in surgery only group reduced in Stage-3 (from 10.5% in Stage-2 to 2.2% in Stage-3). Median OS of Stage-2/ Stage-3 patient were (months): 41.6/15.5 for surgery only, 19.2/13.7 for Chemo-RT and 9.3/6.4 for RT only. All the OS differences were statistically significant (p-value < 0.01).

Conclusion: Although neoadjuvant chemo-RT and surgery is the standard of care for esophageal cancer, this study revealed that a large number of patients were treated in unconventional ways. Despite of unconventional treatment (surgery only) for Stage-2 and Stage-3 patients the OS of these patients were significantly higher than other two types of treatment (RT only or Chemo-RT). The reason may be the differential comorbidity or baseline health conditions and/or other socio-demographic factors. Further work including multivariable analysis is underway.

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