Clinical treatment patterns and patient characteristics in the advanced and metastatic esophageal cancer (EC) population treated in the hospitals from county or prefecture-level cities in high-prevalence areas of China: Real-world data.

Abstract

e16039 Background: About half of the newly diagnosed esophageal cancer (EC) cases worldwide occur in China each year. The distribution of EC patients (pts) in China shows a significant regional concentration. Most advanced or metastatic EC pts receive treatment at nearby hospital rather than national or provincial medical centers. Since the approval of PD-1 inhibitors for the treatment of advanced EC in 2022, immunotherapy has become a common treatment for advanced EC. This study aimed to focus on the patient characteristics and treatment pattern of EC pts treated in the hospitals from county or prefecture-level cities in the era of immunotherapy. Methods: This retrospective observational study utilized electronic health records data of pts with advanced/metastatic EC from 6 medical centers between 1 January 2022 and 1 June 2024. Pts were followed up until the last patient record as of November 1, 2024. Descriptive analyses were performed to evaluate patient and treatment characteristics. Results: A total of 322 pts were included in the study, of which 71.4% were male. The median age was 68.4 years. 79.8% of the pts came from the local county or city, 13.6% were from within the province, and 6.6% were from other provinces. A total of 97.8% of pts sought medical attention due to EC-specific symptoms, and 93.6% were diagnosed with EC through endoscopy. Squamous cell carcinoma of the esophagus accounted for 90.4%. 67.1% advanced-stage pts was progressed from earlier stages of the disease. A total of 126 (39.1%) pts had undergone surgical treatment, of which 97.5% were R0 resection, and 56.3% patients received perioperative treatment. 116 (36%) pts received definitive chemoradiotherapy. At the advanced stage, 126 (39.1%) pts had only lymph node metastasis, and 176 (54.7%) pts had organ metastasis. Among the patients with lymph node metastasis, the most common sites were the mediastinal lymph nodes (64.0%) and supraclavicular lymph nodes (32.0%). Among the patients with organ metastasis, lung metastasis (46.0%) was the most common, followed by liver metastasis (36.9%) and bone metastasis (26.7%). Information on 309 patients who received first-line (1L) treatment was recorded. 88.7% received chemotherapy, including TP (51.1%), FP (14.6%) and single-agent therapy (24.1%). Additionally, 78.3% received PD-1 inhibitor treatment, 7.1% received TKI therapy and 28.2% received radiotherapy. Information on 111 patients who received 2L+ treatment was recorded, and the regimens for subsequent treatments were more diverse. Conclusions: Most advanced EC pts received treatment at local hospitals in high-incidence areas of China. The majority of advanced-stage pts have progressed from earlier stages of the disease. Immunotherapy and chemotherapy are commonly used treatment for advanced EC. Clinical trial information: ChiCTR2400089404 .