Background: The standard of care for locally advanced esophageal cancer is chemoradiation followed by surgery. Age and obesity are risk factors for both esophageal cancer and cardiovascular diseases. In this study, we explored whether the presence of cardiac comorbidities impacted the outcomes of patients who underwent trimodality therapy for esophageal cancer. Methods: After IRB approval, we collected data on patients treated at our center for locally advanced disease and received trimodality treatment. Variables collected were age, gender, race, ethnicity, dates of diagnosis, surgery, recurrence and death when available. We performed a thorough chart review to note any documentation of cardiac conditions such as coronary artery disease, arrhythmias or valvulopathy. Chi-square test was used to analyze categorical variables with Fisher’s exact test used when appropriate. Survival times were estimated using the Kaplan Meier method. Results: From 1997 through Jan 2019, the database identified 187 patients. Majority were male (86%). Median age at diagnosis was 64 years. Most were white (98.4%) and non-Hispanic (97.9%). Heart disease was noted in 27.8% of patients compared to 72.2% without any documented cardiac morbidity. Postoperative mortality rates were not significantly different between patients with or without cardiac comorbidities. The median overall survival was shorter for those with heart disease (35 mos) compared to those without (45 mos), but this not reach statistical significance (p=0.183). Median disease-free survival was also not significantly different. Conclusion: Since esophageal cancer patients require extensive surgical intervention after chemoradiation, cardiac comorbidities sometimes concern us regarding their tolerance to treatment. Some limitations of our study include its retrospective nature and possible incomplete documentation of health problems. Regardless, based on our institutional experience, there was not a significant difference in the survival of patients with locally advanced esophageal cancer based on presence or absence of cardiac comorbidities. Multi-institutional data would be helpful to clarify this. Patients with potentially curable cancer should be offered aggressive treatments to achieve superior outcomes.
HSR21-041: Impact of Cardiac Comorbidities on Outcomes After Treatment for Locally Advanced Esophageal Cancer: An Institutional Experience
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Luis Aguirre
MD
Luis Aguirre
University of South Florida, Tampa, FL
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Jacques Fontaine
MD
Jacques Fontaine
H. Lee Moffitt Cancer Center, Tampa, FL
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Jessica Frakes
MD
Jessica Frakes
H. Lee Moffitt Cancer Center, Tampa, FL
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Sarah Hoffe
MD
Sarah Hoffe
H. Lee Moffitt Cancer Center, Tampa, FL
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Jose Pimiento
MD
Jose Pimiento
H. Lee Moffitt Cancer Center, Tampa, FL
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Rutika Mehta
MD, MPH
Rutika Mehta
H. Lee Moffitt Cancer Center, Tampa, FL
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