% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Apostolidis:179574,
      author       = {L. Apostolidis and K. Lang and L. Sisic and E. Busch and A.
                      Ahadova$^*$ and R. Wullenkord and H. Nienhüser and A.
                      Billeter and B. Müller-Stich and M. Kloor$^*$ and D.
                      Jaeger$^*$ and G. M. Haag$^*$},
      title        = {{O}utcome and prognostic factors in patients undergoing
                      salvage therapy for recurrent esophagogastric cancer after
                      multimodal treatment.},
      journal      = {Journal of cancer research and clinical oncology},
      volume       = {149},
      number       = {4},
      issn         = {0171-5216},
      address      = {Berlin},
      publisher    = {Springer},
      reportid     = {DKFZ-2022-00752},
      pages        = {1373-1382},
      year         = {2023},
      note         = {#LA:D120# / 2023 Apr;149(4):1373-1382},
      abstract     = {Perioperative 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.},
      keywords     = {Esophagogastric cancer (Other) / MSI (Other) /
                      Perioperative treatment (Other) / Relapse (Other) / Salvage
                      treatment (Other)},
      cin          = {F210 / D120},
      ddc          = {610},
      cid          = {I:(DE-He78)F210-20160331 / I:(DE-He78)D120-20160331},
      pnm          = {314 - Immunologie und Krebs (POF4-314)},
      pid          = {G:(DE-HGF)POF4-314},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35441345},
      doi          = {10.1007/s00432-022-04016-y},
      url          = {https://inrepo02.dkfz.de/record/179574},
}