Sex and gender disparities in patients with advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry

ESMO Open

article

J. Gallego Plazas¹  A. Arias-Martinez²  A. Lecumberri³  E. Martínez de Castro⁴  A. Custodio⁵  J.M. Cano⁶  R. Hernandez⁷  A.F. Montes⁸  I. Macias⁹  A. Pieras-Lopez^1,10  M. Diez^1,11  L. Visa^1,12  R.V. Tocino^1,13  N. Martínez Lago^1,14  M.L. Limón^1,15  M. Gil^1,16  P. Pimentel^1,17  M. Mangas^1,18  M. Granja^1,19  A.M. Carnicero^2,20  C. Hernández Pérez^2,21  L.G. Gonzalez^2,22  P. Jimenez-Fonseca^2,23  A. Carmona-Bayonas^2,24 

[1] Medical Oncology Department, Hospital General Universitario de Elche;Pharmacy Department, Hospital Universitario Germans Trias i Pujol;Medical Oncology Department, Hospital Universitario de Navarra;Medical Oncology Department, Hospital Universitario Marqués de Valdecilla;Medical Oncology Department, Hospital Universitario La Paz;Medical Oncology Department, Hospital General Universitario de Ciudad Real;Medical Oncology Department, Hospital Universitario de Canarias;Medical Oncology Department, Complejo Hospitalario de Ourense;Medical Oncology Department, Hospital Universitario Parc Taulí;Pharmacy Department, Hospital Sant Joan de Déu;Medical Oncology Department, Hospital Universitario Vall d’Hebron;Medical Oncology Department, Hospital Universitario El Mar;Medical Oncology Department, Complejo Asistencial Universitario de Salamanca - ISBAL;Medical Oncology Department, Complejo Hospitalario Universitario de A Coruña;Medical Oncology Department, Hospital Universitario Virgen del Rocío;Medical Oncology Department, Hospital General Universitario de Valencia – Ciberonc CB16/12/0035;Medical Oncology Department, Hospital Santa Lucía;Medical Oncology Department, Hospital Galdakao-Usansolo;Medical Oncology Department, Hospital Universitario Clínico San Carlos;Medical Oncology Department, Hospital San Pedro;Medical Oncology Department, Hospital Universitario Nuestra Señora de la Candelaria;Medical Oncology Department, Hospital General Universitario de Alicante;Medical Oncology Department, Hospital Universitario Central de Asturias;Hematology and Medical Oncology Department, Hospital Universitario Morales Meseguer, University of Murcia

关键词: gastroesophageal cancer;    sex;    gender;    survival;    toxicity;   

DOI  :  10.1016/j.esmoop.2022.100514

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background Recommendations for research articles include the use of the term sex when reporting biological factors and gender for identities or psychosocial or cultural factors. There is an increasing awareness of incorporating the effect of sex and gender on cancer outcomes. Thus, these types of analyses for advanced gastroesophageal adenocarcinoma are relevant.Patients and methods Patients with advanced gastroesophageal adenocarcinoma from the Spanish AGAMENON-SEOM registry treated with first-line combination chemotherapy were selected. Epidemiology, characteristics of the disease, treatment selection, and results were examined according to sex.Results This analysis included 3274 advanced gastroesophageal adenocarcinoma patients treated with combination chemotherapy between 2008 and 2021: 2313 (70.7%) men and 961 (29.3%) women. Tumors in females were more frequently HER2-negative (67.8% versus 60.8%; P < 0.0001), grade 3 (45.4% versus 36.8%; P < 0.001), diffuse (43.3% versus 26.5%; P < 0.0001), and signet ring cell histology (40.5 versus 23.9%; P < 0.0001). Peritoneal spread was more common in women (58.6% versus 38.9%; P < 0.0001), while liver burden was lower (58.9% versus 71.1%; P < 0.0001). There were no significant differences in treatment recommendation. Treatment doses, density, and duration were comparable between sexes. Women experienced more diarrhea (46% versus 37%; P < 0.0001), neutropenia (51% versus 43%; P < 0.0001), and anemia (62% versus 57%; P < 0.0001). After a median 59.6-month follow-up [95% confidence interval (CI) 54.5-70.8], there were no statistically significant differences between the sexes in progression-free survival [6.21 months (95% CI 5.8-6.5 months) versus 6.08 months (95% CI 5.8-6.3 months); log-rank test, χ2 = 0.1, 1 df, P = 0.8] or in overall survival [10.6 months (95% CI 9.8-11.1 months) versus 10.9 months (95% CI 10.4-11.4 months); log-rank test: χ2 = 0.6, 1 df, P = 0.5].Conclusion This sex analysis of patients with advanced gastroesophageal adenocarcinoma from the AGAMENON-SEOM registry receiving first-line polychemotherapy found no differences in survival. Although women had worse prognostic histopathology, metastatic disease pattern, and greater toxicity, treatment allocation and compliance were equivalent.

【 授权许可】

CC BY|CC BY-NC-ND