165 Do the guidelines for esophageal cancer treatment need to be gender-stratified?

Abstract Background Esophageal cancer occurs more frequently in males but It is unclear whether the response to neoadjuvant chemoradiotherapy (NCR), or the outcome following treatment are gender specific. Aims The aim of this study was to compare the presentation, response to NCR and outcome in females with males, treated in the same centre. Methods A prospectively maintained database of 205 patients with esophageal carcinoma, treated with curative intention, was interrogated for the influence of gender on the presentation, response and outcome following NCR treatment. Results Of 205 patients, 59 (29%) were female, and were significantly older than males [mean (SD) age 66.1 (10.8) v. 61.4 (11.2) (p=0.008)]. Sixty-six percent (39/59) of females compared to 79.5% of males had adenocarcinoma (AC) (<0.001). The mean age of females with SCC was 66.7 years compared to 58.9 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). Conclusion We found that females were on average 5-years older with a significantly greater cCR rate to NCR versus males. These differences suggest that esophageal cancer behaves differently in females supporting the necessity for gender stratification in randomised trials and management guidelines.