The impact of hiatal hernia on survival outcomes in patients with gastroesophageal junction adenocarcinoma

299 Background: Gastric cancer (GC, including gastroesophageal junction adenocarcinoma) pathways have been implemented and refined since 2010 in the US Oncology Network (USON), a community-practice-based network. This study was designed to evaluate the impact of 4 pathway periods (PP): pre-pathway: pre-Aug ‘10; Level 1: Sept ‘10-Nov ‘14; Clear Value, Dec ‘14-Feb ‘17; Value: After Mar ‘17, on treatment heterogeneity, treatment duration, and overall survival (OS). Methods: Adult patients were eligible if they were treated at a participating USON site and were diagnosed with and treated for GC; follow up was through Mar 2019. Heterogeneity was measured by the Herfindahl-Hirschman Index (HHI), which is evaluated from 0.0 to 1.0 (complete to no heterogeneity). Time to treatment failure (TTF) was defined as initiation of the line of therapy until start of the subsequent line of therapy or death. OS was estimated from start of first-line (1L) therapy. Time-to-event outcomes were estimated using Kaplan-Meier. Results: Of 3191 eligible patients, 2297 received treatment for advanced/metastatic disease. Of these, patient median age was 65.3 years, 60% were male, 70% were initially diagnosed with stage IV disease. Pre-pathway, common 1L regimens were single-agent fluorouracil (15%) and docetaxel-cisplatin-fluorouracil (14%); FOLFOX (45%) was most frequent during the value PP, 941 (41%) received second-line (2L) therapy. During Level 1 PP, single-agent irinotecan (11%) was most common during 2L, whereas in Value PP, ramucirumab+paclitaxel (43%) was most common. HHI and TTF are presented in the table. Median OS was 12.6 months (95% confidence interval, CI: 11.9, 13.5), which did not change significantly over PPs. Conclusions: 1L and 2L heterogeneity was initially high, and was reduced over time; TTF showed modest increase. OS data are limited by high levels of censoring in the latter PPs, which reduces the ability to evaluate changes in more recent years. [Table: see text]

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Gastroesophageal Junction Adenocarcinoma in Iran; a Ret-rospective Study to Investigate Demographic Characteristics and Effect of Multimodality Therapy on Survival Rate

Journal of Biology and Today s World ◽

10.15412/j.jbtw.01070101 ◽

2018 ◽

Vol 7 (1) ◽

Author(s):

M. Mirsadraei ◽

H. Khalili-Hezarjaribi

Keyword(s):

Survival Rate ◽

Gastroesophageal Junction ◽

Demographic Characteristics ◽

Multimodality Therapy ◽

Gastroesophageal Junction Adenocarcinoma

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Collagen type I and III study in the gastroesophageal junction in the patients with hiatal hernia

Surgery of Ukraine ◽

10.30978/su2019-1-34 ◽

2019 ◽

Vol 0 (1) ◽

pp. 34-38

Author(s):

V. V. Grubnyk ◽

T. A. Savenko

Keyword(s):

Hiatal Hernia ◽

Collagen Type ◽

Gastroesophageal Junction ◽

Collagen Type I ◽

Type I

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SHR-1210 Combined With Trastuzumab , Oxaliplatin and Capecitabine for Neoadjuvant Therapy of Gastric Adenocarcinoma/Gastroesophageal Junction Adenocarcinoma

Case Medical Research ◽

10.31525/ct1-nct03950271 ◽

2019 ◽

Author(s):

Keyword(s):

Neoadjuvant Therapy ◽

Gastric Adenocarcinoma ◽

Gastroesophageal Junction ◽

Gastroesophageal Junction Adenocarcinoma

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Chemotherapy Delays Are Associated with Inferior Outcome in Acute Lymphoblastic Leukemia: A Retrospective Study from a Tertiary Cancer Center in South India

Indian Journal of Medical and Paediatric Oncology ◽

10.1055/s-0041-1729513 ◽

2021 ◽

Vol 42 (01) ◽

pp. 051-060

Author(s):

Vineet Agrawal ◽

Smita Kayal ◽

Prasanth Ganesan ◽

Biswajit Dubashi

Keyword(s):

Acute Lymphoblastic Leukemia ◽

Lymphoblastic Leukemia ◽

Univariate Analysis ◽

Cancer Center ◽

Survival Outcomes ◽

Separate Analysis ◽

Term Survival ◽

Free Survival ◽

Intensive Phase ◽

The Impact

Abstract Background Treatment protocols for acute lymphoblastic leukemia (ALL) have evolved over time to give excellent cure rates in children and moderate outcomes in adults; however, little is known how delays in chemotherapy affect long-term survival. Objectives To find the association of delays during different treatment phases on the survival outcomes. Materials and Methods Data from 149 ALL cases treated between 2009 and 2015 were retrospectively analyzed. Treatment course in commonly used protocols was divided into three phases—induction, consolidation (postremission), maintenance, and also a combined intensive phase (induction plus consolidation) for the purpose of analysis, and delay in each phase was defined based on clinically acceptable breaks. Analysis was done to find the impact of treatment delay in each phase on the survival outcomes. Results The median age was 12 years (range, 1–57). Multi-center Protocol-841 (MCP-841) was used for 72%, German Multicenter Study Group for Adult ALL (GMALL) for 19%, and Berlin, Frankfurt, Muenster, 95 protocol (BFM-95) for 9% of patients. Delay in induction was seen in 52%, consolidation in 66%, and during maintenance in 42% of patients. The median follow-up was 41 months, and 3-year survival outcomes for the entire cohort were event-free survival (EFS)—60%, relapse-free survival (RFS)—72%, and overall survival (OS)—68%. On univariate analysis, delay in induction adversely affected EFS (hazard ratio [HR] = 1.78, p = 0.04), while delay in intensive phase had significantly worse EFS and RFS (HR = 2.41 [p = 0.03] and HR = 2.57 [p = 0.03], respectively). On separate analysis of MCP-841 cohort, delay in intensive phase affected both EFS (HR = 3.85, p = 0.02) and RFS (HR = 3.42, p = 0.04), whereas delay in consolidation significantly affected OS with (HR = 4.74, p = 0.04) independently. Conclusion Treatment delays mostly in intensive phase are associated with worse survival in ALL; attempts should be made to maintain protocol-defined treatment intensity while adequately managing toxicities.

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