494. DO WE NEED GENDER SPECIFIC GUIDELINES FOR ESOPHAGEAL CANCER MANAGEMENT?

Abstract Background The incidence of esophageal cancer is disproportionately greater in males, but trials of treatments are not gender stratified. It is unclear whether the response or outcome following neoadjuvant chemoradiotherapy (NCR) is gender specific. This study compared the presentation, response to NCR and outcome of female with male patients. (48) Methods A prospectively maintained database of 205 esophageal carcinoma patients treated with curative intent between 1998 and 2019 was interrogated for the impact of gender on presentation, response to NCR treatment and survival. (32 words) Results Of 205 patients, 59 (29%) females were significantly older than males [mean (SD) age 66.1 (10.8) v. 61.6 (11.2) (p=0.008)]. Sixty-six percent of females had squamous cell carcinoma (SCC) while 116 (79.5%) males had adenocarcinoma (AC) (<0.001). Females with SCC had a mean age 66.7 years versus 58.9 years for males (p=0.006). Seventy-eight percent of females had a clinical complete response (cCR), versus 43.8% of males (P<0.001). Sixty-nine percent of females with AC had a cCR versus 39% of males (p=0.04). Controlling for age, diagnostic stage and treatment type, females survived significantly longer than males [HR 0.71 CI 0.52-0.98 (p=0.035)]. (100 words) Conclusion This study found that females were on average a decade older with a significantly greater cCR rate, and a superior survival advantage compared to males. This suggests that randomized trials should stratify for gender. (35 words)