TY - JOUR
T1 - A population-based study on treatment and outcomes in patients with gastric adenocarcinoma diagnosed with distant interval metastases
AU - Dijksterhuis, Willemieke P. M.
AU - Kroese, Tiuri E.
AU - Verhoeven, Rob H. A.
AU - van Rossum, Peter S. N.
AU - Mook, Stella
AU - Haj Mohammad, Nadia
AU - Hulshof, Maarten C. C. M.
AU - Gisbertz, Suzanne S.
AU - Ruurda, Jelle P.
AU - van Oijen, Martijn G. H.
AU - van Hillegersberg, Richard
AU - van Laarhoven, Hanneke W. M.
N1 - Funding Information: RHAV reports grants from BMS and Roche. NHM reports a consult/advisory role for BMS, MSD Servier, Eli Lilly, reserach grant from Servier. SSG reports a research grant from Olympus and consulting fees from Medtronic. MGHvO reports grants from Amgen, BMS, Lilly, Nordic, Merck, Roche and Servier. HWMvL reports a consult/advisory role for BMS, Celgene, Lilly, Merck, and Nordic, and Servier and has received unrestricted research funding from Bayer, BMS, Celgene, Lilly, Merck Serono, MSD, Nordic, Philips, Roche and Servier. The other authors declare that they have no conflicts of interest. Publisher Copyright: © 2022 The Authors
PY - 2022/9
Y1 - 2022/9
N2 - Background: In patients with gastric or gastroesophageal junction (GEJ) cancer treated with curative intent, distant interval metastases may be detected after start of neoadjuvant chemotherapy or during surgery. The aim of this study was to explore characteristics, allocated treatment and overall survival (OS) in gastric/GEJ cancer patients with interval metastases, and to compare OS with synchronous metastatic gastric/GEJ cancer patients who started palliative chemotherapy. Methods: Patients with interval metastases were selected from the Netherlands Cancer Registry by including patients with potentially curable gastric/GEJ adenocarcinoma (2010–2018) who started chemotherapy without concurrent radiotherapy. The OS since start of neoadjuvant treatment of patients with interval metastases was compared with a propensity score-matched cohort of patients with synchronous metastases who received palliative systemic treatment. Results: 164 patients with interval metastases diagnosed in 2010–2018 were included. Metastases were most frequently detected during surgery (83%) and most frequently located in the peritoneum (77%). Peritoneal interval metastases were observed in 63% and 80% of the patients who did and did not have a diagnostic laparoscopy prior to neoadjuvant treatment, respectively (P = 0.041). Median OS was 8.9 months (IQR 5.5–13.4), compared to 8.0 months (IQR 4.1–14.1) in matched synchronous metastatic patients calculated from start of neoadjuvant and palliative systemic treatment, respectively (P = 0.848). Conclusion: This population-based study shows that gastric/GEJ cancer patients who started neoadjuvant treatment and were diagnosed with interval metastases most frequently suffered from peritoneal metastases detected during (exploratory) surgery, even when a diagnostic laparoscopy was performed before start of treatment. OS was comparable to patients with synchronous metastatic gastric/GEJ cancer.
AB - Background: In patients with gastric or gastroesophageal junction (GEJ) cancer treated with curative intent, distant interval metastases may be detected after start of neoadjuvant chemotherapy or during surgery. The aim of this study was to explore characteristics, allocated treatment and overall survival (OS) in gastric/GEJ cancer patients with interval metastases, and to compare OS with synchronous metastatic gastric/GEJ cancer patients who started palliative chemotherapy. Methods: Patients with interval metastases were selected from the Netherlands Cancer Registry by including patients with potentially curable gastric/GEJ adenocarcinoma (2010–2018) who started chemotherapy without concurrent radiotherapy. The OS since start of neoadjuvant treatment of patients with interval metastases was compared with a propensity score-matched cohort of patients with synchronous metastases who received palliative systemic treatment. Results: 164 patients with interval metastases diagnosed in 2010–2018 were included. Metastases were most frequently detected during surgery (83%) and most frequently located in the peritoneum (77%). Peritoneal interval metastases were observed in 63% and 80% of the patients who did and did not have a diagnostic laparoscopy prior to neoadjuvant treatment, respectively (P = 0.041). Median OS was 8.9 months (IQR 5.5–13.4), compared to 8.0 months (IQR 4.1–14.1) in matched synchronous metastatic patients calculated from start of neoadjuvant and palliative systemic treatment, respectively (P = 0.848). Conclusion: This population-based study shows that gastric/GEJ cancer patients who started neoadjuvant treatment and were diagnosed with interval metastases most frequently suffered from peritoneal metastases detected during (exploratory) surgery, even when a diagnostic laparoscopy was performed before start of treatment. OS was comparable to patients with synchronous metastatic gastric/GEJ cancer.
KW - Drug therapy
KW - Gastric neoplasms
KW - Neoadjuvant therapy
KW - Neoplasm metastases
UR - http://www.scopus.com/inward/record.url?scp=85126636825&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejso.2022.03.003
DO - https://doi.org/10.1016/j.ejso.2022.03.003
M3 - Article
C2 - 35314096
SN - 0748-7983
VL - 48
SP - 1964
EP - 1971
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 9
ER -