Intensive surveillance following esophageal cancer may improve outcomes
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Intensive surveillance following esophageal cancer surgery improved oncologic outcomes, according to data presented at ASCO 2021.
This was especially true for patients who presented with the disease at an early stage, or who had a favorable pathological stage following induction therapy, according to the researchers.
In a video presentation, Jessie A Elliott, MD PhD, of the department of surgery at Trinity St. James Cancer Institute in Dublin, Ireland, said that these results may lead toward more consistent guidelines.
"Although established and emerging therapies for recurrent esophageal cancer may impact on survival and quality of life, surveillance protocols after primary curative treatment are very inconsistent, likely reflecting limited evidence," Elliot said.
Elliot described how intensive surveillance affects treatment outcomes, as demonstrated by the multicenter retrospective observational study.
"Intensive surveillance is associated with increased probability of receiving tumor-directed therapy following recurrence. And this highlights that an aggressive treatment approach, and to the management of recurrent disease, may be associated with improved outcomes in some patients," she said.
The study included data from 4,682 patients. The participants received treatment with curative intent surgery for esophageal or junctional cancer between 2009 and 2015 with 69% undergoing neoadjuvant therapy.
Half of the patients were subject to intensive surveillance following treatment, according to the study, which is the largest to date to look at how intensive surveillance impacts outcomes for patients with esophageal and junctional cancers.
Patients who received intensive surveillance were more likely to experience recurrence of symptoms, to have increased tumor-directed therapy, and showed higher levels of overall survival, the researchers wrote. Further, intensive surveillance also resulted in higher levels of anxiety and overall health-related quality of life was not negatively affected, according to the investigators.
"We feel, overall, that the present results may inform shared decision-making with our patients, and could be incorporated into future clinical guidelines," Elliot said.
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Elliott J, et al. Abstract 4032. Presented at: ASCO Annual Meeting; June 4-8, 2021 (virtual meeting).
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