Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study
Background and purpose: This nationwide population-based study analyzed the outcomes of local treatment (i.e. stereotactic body radiotherapy [SBRT] or metastasectomy) or systemic therapy for oligometastatic disease (OMD) in patients with esophagogastric cancer in The Netherlands. Materials and metho...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Clinical and Translational Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S240563082200074X |
| _version_ | 1811247938059370496 |
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| author | Tiuri E. Kroese Nikita K.N. Jorritsma Hanneke W.M. van Laarhoven Rob H.A. Verhoeven Stella Mook Nadia Haj Mohammad Jelle P. Ruurda Peter S.N. van Rossum Richard van Hillegersberg |
| author_facet | Tiuri E. Kroese Nikita K.N. Jorritsma Hanneke W.M. van Laarhoven Rob H.A. Verhoeven Stella Mook Nadia Haj Mohammad Jelle P. Ruurda Peter S.N. van Rossum Richard van Hillegersberg |
| author_sort | Tiuri E. Kroese |
| collection | DOAJ |
| description | Background and purpose: This nationwide population-based study analyzed the outcomes of local treatment (i.e. stereotactic body radiotherapy [SBRT] or metastasectomy) or systemic therapy for oligometastatic disease (OMD) in patients with esophagogastric cancer in The Netherlands. Materials and methods: Between 2015 and 2016, all patients in The Netherlands with esophagogastric cancer and synchronous or metachronous OMD were eligible for inclusion. Patients who underwent local treatment of OMD (SBRT or metastasectomy) and/or systemic therapy were included. OMD was defined as distant metastases in 1 organ or 1 extra-regional lymph node region. The primary outcomes were overall survival (OS) and independent prognostic factors for OS. OS was calculated from diagnosis of OMD. Prognostic factors for OS were analyzed using a multivariable Cox proportional hazard model. Results: A total of 594 patients were included, of whom 83 underwent local treatment for OMD alone, 22 local treatment plus systemic therapy, and 489 systemic therapy alone. Median OS after local treatment for OMD alone was 16.0 months, local treatment plus systemic therapy 22.7 months, and after systemic therapy alone 8.5 months. Improved OS was independently associated with local treatment for OMD alone or combined with systemic therapy as compared with systemic therapy alone (hazard ratio [HR] 0.52, 95% CI: 0.31–0.90 and HR 0.42, 95% CI: 0.22-0.82, respectively) and a controlled primary tumor(HR 0.48, 95% CI: 0.27–0.86). Worse OS was independently associated with worse performance scores (HR 1.41, 95%: 1.32-1.75), poorly or undiffertumor as compared with good or moderadifferentiated tumor (HR 1.37, 95% CI: 1.06-1.76), and peritoneal as compared with lymph mode metastases (HR 1.39, 95% CI: 1.00-1.93). Conclusion: Local treatment of OMD alone or combined with systemic therapy was independently associated with improved OS as compared with systemic therapy alone in this population-based cohort study in The Netherlands. Randomized controlled trials are warranted to confirm these results. |
| first_indexed | 2024-04-12T15:18:09Z |
| format | Article |
| id | doaj.art-34fdc2f686cd4a38ac089f55818286af |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-04-12T15:18:09Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-34fdc2f686cd4a38ac089f55818286af2022-12-22T03:27:33ZengElsevierClinical and Translational Radiation Oncology2405-63082022-11-0137109115Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort studyTiuri E. Kroese0Nikita K.N. Jorritsma1Hanneke W.M. van Laarhoven2Rob H.A. Verhoeven3Stella Mook4Nadia Haj Mohammad5Jelle P. Ruurda6Peter S.N. van Rossum7Richard van Hillegersberg8Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Corresponding author at: Department of Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Department of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Medical Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Medical Oncology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The NetherlandsDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsDepartment of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The NetherlandsBackground and purpose: This nationwide population-based study analyzed the outcomes of local treatment (i.e. stereotactic body radiotherapy [SBRT] or metastasectomy) or systemic therapy for oligometastatic disease (OMD) in patients with esophagogastric cancer in The Netherlands. Materials and methods: Between 2015 and 2016, all patients in The Netherlands with esophagogastric cancer and synchronous or metachronous OMD were eligible for inclusion. Patients who underwent local treatment of OMD (SBRT or metastasectomy) and/or systemic therapy were included. OMD was defined as distant metastases in 1 organ or 1 extra-regional lymph node region. The primary outcomes were overall survival (OS) and independent prognostic factors for OS. OS was calculated from diagnosis of OMD. Prognostic factors for OS were analyzed using a multivariable Cox proportional hazard model. Results: A total of 594 patients were included, of whom 83 underwent local treatment for OMD alone, 22 local treatment plus systemic therapy, and 489 systemic therapy alone. Median OS after local treatment for OMD alone was 16.0 months, local treatment plus systemic therapy 22.7 months, and after systemic therapy alone 8.5 months. Improved OS was independently associated with local treatment for OMD alone or combined with systemic therapy as compared with systemic therapy alone (hazard ratio [HR] 0.52, 95% CI: 0.31–0.90 and HR 0.42, 95% CI: 0.22-0.82, respectively) and a controlled primary tumor(HR 0.48, 95% CI: 0.27–0.86). Worse OS was independently associated with worse performance scores (HR 1.41, 95%: 1.32-1.75), poorly or undiffertumor as compared with good or moderadifferentiated tumor (HR 1.37, 95% CI: 1.06-1.76), and peritoneal as compared with lymph mode metastases (HR 1.39, 95% CI: 1.00-1.93). Conclusion: Local treatment of OMD alone or combined with systemic therapy was independently associated with improved OS as compared with systemic therapy alone in this population-based cohort study in The Netherlands. Randomized controlled trials are warranted to confirm these results.http://www.sciencedirect.com/science/article/pii/S240563082200074XEsophageal cancerGastric cancerMetastasectomyStereotactic radiation therapyOligometastasis |
| spellingShingle | Tiuri E. Kroese Nikita K.N. Jorritsma Hanneke W.M. van Laarhoven Rob H.A. Verhoeven Stella Mook Nadia Haj Mohammad Jelle P. Ruurda Peter S.N. van Rossum Richard van Hillegersberg Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study Clinical and Translational Radiation Oncology Esophageal cancer Gastric cancer Metastasectomy Stereotactic radiation therapy Oligometastasis |
| title | Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study |
| title_full | Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study |
| title_fullStr | Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study |
| title_full_unstemmed | Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study |
| title_short | Stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer: A nationwide population-based cohort study |
| title_sort | stereotactic radiotherapy or metastasectomy for oligometastatic esophagogastric cancer a nationwide population based cohort study |
| topic | Esophageal cancer Gastric cancer Metastasectomy Stereotactic radiation therapy Oligometastasis |
| url | http://www.sciencedirect.com/science/article/pii/S240563082200074X |
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