# Lack of association between prior or concurrent malignancies and overall survival in gastroesophageal cancer: evidence from a large European single-center cohort

## TL;DR

A study of 1491 gastroesophageal cancer patients found that having prior or concurrent cancers does not affect survival, suggesting such patients should not be excluded from clinical trials.

## Contribution

This is the first large European cohort study showing no survival impact of prior or concurrent malignancies in gastroesophageal cancer patients.

## Key findings

- 255 (18%) of 1491 patients had prior or concurrent malignancies.
- History of other cancers was associated with older age and squamous cell histology but not with overall survival.
- Patients with multiple malignancies did not have worse survival outcomes.

## Abstract

History of malignant disease is a common exclusion criterion in clinical cancer trials, yet data on the impact of cancer survivorship on outcome in gastroesophageal cancer patients are scarce.

Retrospective association analyses of self-reported prior or concurrent malignancies with patient characteristics, tumor characteristics, symptoms and overall survival (OS) were performed in 1491 gastroesophageal cancers patients treated between 01/01/2000 and 31/12/2021 at the Medical University of Vienna.

Of 1491 patients 255 (18%) had other primary cancer diagnoses, of which 185 (73%) occurred before, 52 (20%) at the same time as and 18 (7%) both before and at the same time as gastroesophageal cancer diagnosis. 205 (80%) patients had one, 43 (17%) had 2 and 7 (3%) had 3 other malignancies. History of other malignancies was associated with older age (p < 0.0001), squamous cell histology (p = 0.018), less aggressive localized tumor stages (p = 0.037) and fewer acid reflux (p = 0.011). There was neither an association between history of other primary malignancies nor the number of other cancer entities and OS (p = 0.47; p = 0.43).

Self-reported history of other malignant diseases is frequent in a real-life European gastroesophageal cancer cohort and was not statistically significantly associated with outcome, but rather with older age and squamous cell histology. Our data emphasize that cancer survivors should not be categorically excluded from clinical cancer trials due to fear of dismal prognosis. Prospective research is warranted to improve eligibility for this subgroup.

The online version contains supplementary material available at 10.1007/s12094-025-04036-3.