Real-world clinicopathologic features and outcomes of gastric, esophageal, and gastroesophageal junction cancers: A single-center cohort study.

Abstract

e16057 Background: Upper gastrointestinal cancers encompass biologically and clinically distinct entities with evolving management paradigms. Despite shared anatomic boundaries, gastric, esophageal, and gastroesophageal junction (GEJ) cancers differ in histology, metastatic behavior, and treatment strategies. Real-world data on presentation, treatment, and outcomes remain limited. We evaluated clinicopathologic characteristics and survival outcomes among patients (pts) with gastric, esophageal, and GEJ cancers treated at a tertiary referral center. Methods: We conducted a retrospective review of pts diagnosed with cancer at the American University of Beirut Medical Center between 2016 and 2024. Patients who verbally consented to be part of the oncology database, presenting with gastric, esophageal, or GEJ cancers and complete clinical data were included. Descriptive statistics were used to summarize clinicopathologic characteristics. Results: A total of 1,118 pts diagnosed with GI cancers were reviewed among whom 212 pts (159 gastric, 25 esophageal, 28 GEJ) were included. Baseline demographic and clinicopathologic characteristics are summarized in Table 1. Advanced-stage disease was common across tumor types, with the highest burden of stage IV disease observed in gastric cancers. Histologic distribution differed by tumor location, with adenocarcinoma predominating in gastric and GEJ tumors, whereas esophageal cancers exhibited greater histologic heterogeneity. The most frequent metastatic sites were liver (20%) and peritoneum (18%), followed by bone (4%) and lung (1%). Surgical resection and first-line chemotherapy utilization varied by tumor type, with surgery performed most frequently in GEJ cancers. First-line systemic therapy was administered to 69%, 92%, and 89% of pts with gastric, esophageal, and GEJ cancers, respectively. Survival outcomes differed across groups, with the highest survival observed in gastric cancer and the lowest in esophageal cancer. The 1-, 2-, and 5-year overall survival rates were 97%, 89%, and 74%, respectively. Conclusions: Despite shared anatomic proximity, gastric, esophageal, and GEJ cancers demonstrated distinct patterns of presentation, histology, treatment, and survival in this real-world cohort. These findings underscore the clinical heterogeneity of upper gastrointestinal malignancies and support tumor-specific risk stratification and management approaches. Baseline characteristics and outcomes by tumor type. Variable Gastric (n=159) Esophageal (n=25) GEJ (n=28) Age (years) 66 (25-89) 58 (35-77) 64 (33-81) Mean BMI (kg/m²) 23.3 22.2 23.1 Female, n (%) 75 (47%) 9 (36%) 6 (21%) Stage IV, n (%) 99 (62%) 12 (48%) 14 (50%) Histology, n (%)AdenocarcinomaSquamous cell carcinoma 132 (83%)- 10 (40%)9 (36%) 25 (89%)3 (11%)