Absence of treatment noted in many patients with advanced UGI cancer

Several patients with advanced upper gastrointestinal (UGI) cancer do not receive treatment, reveals a study in an urban safety-net population.

Using a tumour registry database, the researchers identified patients diagnosed with esophageal squamous (ES), esophageal adenocarcinoma (EA), and gastric carcinomas at JPS Health Network in Fort Worth, Texas, US, from 1 January 2018 to 31 December 2022. They assessed the electronic health records for clinical characteristics, pathology variables, and management outcomes.

The research team used Kaplan‒Meier curve to show the difference in survival time across cancer stages from an index date of diagnosis with censoring at date of last contact.

Some 171 patients (median age 57 years, 71 percent male, 40 percent Hispanic, and 65 percent uninsured) were included in the analysis. The most common primary site was gastric (54 percent), followed by EA (34 percent) and ES (12 percent).

Of the 125 patients with stage 4B UGI cancer, 69 (55 percent) received no treatment, six received only palliative radiation, while the rest received systemic therapy. The median overall survival among stage 4B patients with systemic treatment was 7.9 months (95 percent confidence interval [CI], 6.7‒11) compared with 2.1 months (95 percent CI, 1.5‒3.0) among those without any treatment.

“Interventions to improve outcomes must consider the unique socioeconomic needs of this vulnerable population to translate clinical trial results into improved outcomes,” the researchers said.