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000179574 1001_ $$aApostolidis, Leonidas$$b0
000179574 245__ $$aOutcome and prognostic factors in patients undergoing salvage therapy for recurrent esophagogastric cancer after multimodal treatment.
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000179574 500__ $$a#LA:D120# / 2023 Apr;149(4):1373-1382
000179574 520__ $$aPerioperative systemic treatment has significantly improved the outcome in locally advanced esophagogastric cancer. However, still the majority of patients relapse and die. Data on the optimal treatment after relapse are limited, and clinical and biological prognostic factors are lacking.Patients with a relapse after neoadjuvant/perioperative treatment and surgery for esophagogastric cancer were analyzed using a prospective database. Applied treatment regimens, clinical prognostic factors and biomarkers were analyzed.Of 246 patients 119 relapsed. Among patients with a relapse event, those with an early relapse (< 6 months) had an inferior overall survival (OS 6.3 vs. 13.8 months, p < 0.001) after relapse than those with a late relapse (> 6 months). OS after relapse was longer in patients with a microsatellite-unstable (MSI) tumor. Systemic treatment was initiated in 87 patients (73% of relapsed pat.); among those OS from the start of first-line treatment was inferior in patients with an early relapse with 6.9 vs. 10.0 months (p = 0.037). In 27 patients (23% of relapsed pat.), local therapy (irradiation or surgical intervention) was performed due to oligometastatic relapse, resulting in a prolonged OS in comparison to patients without local therapy (median OS 35.2 months vs. 7.8 months, p < 0.0001). Multivariate analysis confirmed the prognostic benefit of the MSI status and a local intervention.Patients relapsing after multimodal treatment have a heterogeneous prognosis depending on the relapse-free interval (if systemic treatment applied), extent of metastatic disease as well as MSI status. The benefit of additional local intervention after relapse should be addressed in a randomized trial.
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000179574 650_7 $$2Other$$aEsophagogastric cancer
000179574 650_7 $$2Other$$aMSI
000179574 650_7 $$2Other$$aPerioperative treatment
000179574 650_7 $$2Other$$aRelapse
000179574 650_7 $$2Other$$aSalvage treatment
000179574 7001_ $$aLang, Kristin$$b1
000179574 7001_ $$aSisic, Leila$$b2
000179574 7001_ $$aBusch, Elena$$b3
000179574 7001_ $$0P:(DE-He78)07eef6d38a91f4642c810745c5bf5000$$aAhadova, Aysel$$b4$$udkfz
000179574 7001_ $$aWullenkord, Ramona$$b5
000179574 7001_ $$aNienhüser, Henrik$$b6
000179574 7001_ $$aBilleter, Adrian$$b7
000179574 7001_ $$aMüller-Stich, Beat$$b8
000179574 7001_ $$0P:(DE-He78)3121b75683af3772ca9289d447889ed9$$aKloor, Matthias$$b9
000179574 7001_ $$0P:(DE-HGF)0$$aJaeger, Dirk$$b10
000179574 7001_ $$0P:(DE-He78)f54d0426f2215c539d3a7ae1b400b57d$$aHaag, Georg Martin$$b11$$eLast author$$udkfz
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