Prognosis after neoadjuvant chemoradiation or chemotherapy for locally advanced gastro-oesophageal junctional adenocarcinoma

被引：11

作者：

Vos, E. L. ^{[1
]}

Carr, R. A. ^{[2
]}

Hsu, M. ^{[3
]}

Nakauchi, M. ^{[1
]}

Nobel, T. ^{[4
]}

Russo, A. ^{[5
]}

Barbetta, A. ^{[6
]}

Tan, K. S. ^{[3
]}

Tang, L. ^{[7
,8
]}

Ilson, D. ^{[9
]}

Ku, G. Y. ^{[9
]}

Wu, A. J. ^{[10
]}

Janjigian, Y. Y. ^{[9
]}

Yoon, S. S. ^{[1
]}

Bains, M. S. ^{[2
]}

Jones, D. R. ^{[2
]}

Coit, D. ^{[1
]}

Molena, D. ^{[2
]}

Strong, V. E. ^{[1
]}

机构：

[1] Mem Sloan Kettering Canc Ctr, Dept Surg, Gastr & Mixed Tumor Serv, New York, NY 10065 USA

[2] Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Serv, New York, NY 10065 USA

[3] Mem Sloan Kettering Canc Ctr, Dept Bioinformat, New York, NY 10065 USA

[4] Mt Sinai Hlth Syst, Dept Surg, New York, NY USA

[5] Univ Massachusetts, Sch Med, Dept Surg, Worcester, MA USA

[6] Univ Southern Calif, Dept Surg, Los Angeles, CA 90007 USA

[7] Mem Sloan Kettering Canc Ctr, Dept Pathol, Expt Pathol Serv, New York, NY 10065 USA

[8] Mem Sloan Kettering Canc Ctr, Dept Pathol, Gastrointestinal Pathol Serv, New York, NY 10065 USA

[9] Mem Sloan Kettering Canc Ctr, Dept Med, Gastrointestinal Oncol Serv, New York, NY 10065 USA

[10] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10065 USA

来源：

BJS-BRITISH JOURNAL OF SURGERY | 2021年 / 108卷 / 11期

基金：

美国国家卫生研究院;

关键词：

PREOPERATIVE CHEMORADIATION; PERIOPERATIVE CHEMOTHERAPY; ESOPHAGEAL; SURGERY; CANCER; CHEMORADIOTHERAPY; THERAPY;

D O I：

10.1093/bjs/znab228

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Trials typically group cancers of the gastro-oesophageal junction (GOJ) with oesophageal or gastric cancer when studying neoadjuvant chemoradiation and perioperative chemotherapy, so the results may not be fully applicable to GOJ cancer. Because optimal neoadjuvant treatment for GOJ cancer remains controversial, outcomes with neoadjuvant chemoradiation versus chemotherapy for locally advanced GOJ adenocarcinoma were compared retrospectively. Methods: Data were collected from all patients who underwent neoadjuvant treatment followed by surgery for adenocarcinoma located at the GOJ at a single high-volume institution between 2002 and 2017. Postoperative major complications and mortality were compared between groups using Fisher's exact test. Overall survival (OS) and disease-free survival (DFS) were assessed by log rank test and multivariable Cox regression analyses. Cumulative incidence functions were used to estimate recurrence, and groups were compared using Gray's test. Results: Of 775 patients, 650 had neoadjuvant chemoradiation and 125 had chemotherapy. These groups were comparable in terms of clinical tumour and lymph node categories, although the chemoradiation group had greater proportions of white men, complete pathological response to chemotherapy, and smaller proportions of diffuse cancer, poor differentiation, and neurovascular invasion. Postoperative major complications (20.0 versus 17.6 per cent) and 30-day mortality (1.7 versus 1.6 per cent) were not significantly different between the chemoradiation and chemotherapy groups. After adjustment, type of therapy (chemoradiation versus chemotherapy) was not significantly associated with OS (hazard ratio (HR) 1.26, 95 per cent c.i. 0.96 to 1.67) or DFS (HR 1.27, 0.98 to 1.64). Type of recurrence (local, regional, or distant) did not differ after neoadjuvant chemoradiation versus chemotherapy. Conclusion: In patients undergoing surgical resection for locally advanced adenocarcinoma of the GOJ, OS and DFS did not differ significantly between patients who had neoadjuvant chemoradiation compared with chemotherapy.

引用

页码：1332 / 1340

页数：9

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