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Postoperative Adjuvant Chemotherapy Improves Survival Outcomes for Patients With Gastroesophageal Junction Adenocarcinoma
Postoperative adjuvant chemotherapy following D2 gastrectomy was associated with an improved overall survival and disease-free survival for patients with operable stage 2/3 gastroesophageal junction (GEJ) adenocarcinoma, according to a study.
Due to the small proportion of GEJ adenocarcinoma included in previous clinical trials, Run-Cong Nie, MD, PhD, SunYat-sen University Cancer Center, Guangzhou, China, and coauthors, stated, “whether [GEJ adenocarcinoma] patients can benefit from adjuvant chemotherapy remains unclear.”
This study included 927 patients with stage 2/3 GEJ adenocarcinoma who underwent curative surgery across 3 high-volume institutions in China. Patients received either surgery alone (n = 231) or surgery plus postoperative chemotherapy (n = 696). Primary outcomes for the study were overall survival and disease-free survival.
At a median follow-up duration of 39 months, the 5-year overall survival was 63.1% in the chemotherapy group and 50.2% in the surgery-only group (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.54 to 0.88; P = .003). The 5-year disease-free survival was 35.4% in the chemotherapy group and 16.6% in the surgery-only group (HR, 0.66; 95% CI, 0.53 to 0.83; P <.001). Following propensity score matching, the survival benefit observed with adjuvant chemotherapy was maintained. That benefit was further demonstrated upon multivariate analysis of overall survival (HR, 0.63; P <.001) and disease-free survival (HR, 0.52; P <.001).
Dr Nie et al concluded, “Postoperative adjuvant chemotherapy was associated with improved overall survival and disease-free survival in patients with operable stage II or III [GEJ adenocarcinoma] after D2 gastrectomy.”
Source:
Nie R-C, Luo T-Q, Li G-D, et al. Adjuvant chemotherapy for patients with adenocarcinoma of th e esophagogastric junction: A retrospective, multicenter, observational study. Ann Surg Oncol. Published online: December 24, 2022. doi:10.1245/s10434-022-12830-4
