OUTCOMES AND PROGNOSTIC FACTORS IN OLIGOMETASTATIC ESOPHAGEAL CANCER PATIENTS UNDERGOING CURATIVE-INTENT TREATMENT heidi.paine@nhs.net

311-01

OUTCOMES AND PROGNOSTIC FACTORS IN OLIGOMETASTATIC ESOPHAGEAL CANCER PATIENTS UNDERGOING CURATIVE-INTENT TREATMENT

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Lorenzo Ferri lorenzo.ferri@mcgill.ca McGill University Health Centre Thoracic Surgery Montreal Canada

Canada

Oral or Poster

Oligometastatic esophageal cancer (OEC) represents an intermediate stage between localized and widespread disease. Currently, curative-intent multimodal treatments are being trialled, though the patients likely to benefit, and ideal treatment regimens, remain unknown. We describe the oligometastatic experience of a high-volume esophageal centre with focus on identifying potentially favourable prognostic factors.

Patients with OEC who underwent curative-intent esophagectomy 2007-2024 were identified from a prospectively-maintained database. Adenocarcinomas (ADC) and squamous cell carcinomas (SCC) were included; oligometastatic disease was defined by the OMEC criteria. Patients found to have oligometastases at esophagectomy, and those with metachronous oligometastases, were excluded. Descriptive statistics were used.

38 patients met inclusion criteria. Most tumors were adenocarcinomas (92%), predominantly junctional (92%). Metastatic site: non-regional lymph nodes (61%), liver (13%), lung (11%), bone (11%), limited peritoneal (3%) and brain (2%). Perioperative taxane-based chemotherapy and neoadjuvant chemoradiation were used in ADC and SCC respectively, with additional biomarker-directed therapies in nine patients. 25 patients (66%) underwent metastasis-directed therapy, most commonly surgical resection at esophagectomy (n=23). One underwent surgery and radiotherapy to a bone metastasis pre-esophagectomy, and one had intra-operative liver ablation. No metastectomy-specific treatment complications or readmissions were observed within 30 days. Median survival was 23 months (IQR 9.25-77.75) overall, with 30 months (IQR 9.75-29) for non-regional lymph node metastasis and 16 months (IQR 9.25-27) for non-nodal metastases.

Curative-intent treatment for OEC is feasible and safe. Treatment of non-regional lymph node metastases may confer a favourable prognosis over other sites. Prospective multicentre studies will further inform optimal patient selection and treatment strategies.