400 OUTCOME OF PATIENTS THAT DO NOT UNDERGO RESECTION AFTER NEOADJUVANT TREATMENT FOR CANCER OF THE ESOPHAGUS. (17th September 2021)

• Record Type: Journal Article
• Authors: Cutforth, Iona; Brown, Joshua; Chmelo, Jakub; Navidi, Maziar; Wahed, Shajahan; Immanuel, Arul; Phillips, Alex W
• Is Part Of: Diseases of the esophagus. Volume 34(2021)Supplement 1
• Publication Date: 2021-09-17
• Subjects: Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doab052.400
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: : Patients with locally advanced esophageal cancer usually receive neoadjuvant treatment prior to surgery. A proportion of patients will not receive their surgery due to disease progression. Little is known about what happens to these patients and their prognosis. The aim of this study was to evaluate outcomes in patients that have received neoadjuvant treatment but not undergone esophagectomy. Methods: A review of a contemporaneously maintained database of all patients that underwent neoadjuvant treatment for esophageal adenocarcinoma, or squamous cell carcinoma (SCC) but did not have a subsequent esophagectomy was carried out. Patients that were diagnosed with cancer between January 2009 and December 2018 were included. All patients underwent a standardised staging protocol, and were restaged on completion of their neoadjuvant treatment. Overall survival from the date of their initial staging CT and any subsequent treatments were recorded. Results: Over the time period 927 patients received neoadjuvant treatment, and 107 did not progress to surgery. Of the 107, 106 received neoadjuvant chemotherapy and one chemoradiotherapy. 83 of the 107 were adenocarcinoma and 24 SCC. The median age of patients who had surgery was 66 compared to 67 for those that did not. Overall median survival for patients not having surgery was 328.5 days. 40 patients had subsequent oncological treatments. Median survival for patients who received no further treatment was 264 days, palliative chemotherapy 412 days palliative radiotherapy 418.5 days and any combination of the two was 390.5 days. Conclusion: These results show median survival after disease progression during neoadjuvant treatment was over 10 months and this was extended with further oncological treatment with radiotherapy prolonging survival times the most to over 13 months. This information can help when counselling patients to potential treatment options.