Perioperative chemotherapy vs. neoadjuvant chemoradiation in gastroesophageal junction adenocarcinoma
| العنوان: | Perioperative chemotherapy vs. neoadjuvant chemoradiation in gastroesophageal junction adenocarcinoma |
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| المؤلفون: | Alexander L. Gerbes, Helmut Friess, Bernhard H. F. Weber, Roland M. Schmid, Stephanie E. Combs, Daniel Habermehl, Wolfgang D. Schmitt, Gabriele Schubert-Fritschle, Renate Eckel, Jutta Engel, Natascha C. Nüssler, Jens Werner, Claus Belka, Stefan Münch, Ayman Agha, Wolfgang Schepp |
| المصدر: | Strahlentherapie und Onkologie. 194:125-135 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Esophageal Neoplasms, Adenocarcinoma, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Gastrectomy, Stomach Neoplasms, Germany, Internal medicine, medicine, Carcinoma, Humans, Radiology, Nuclear Medicine and imaging, Cumulative incidence, Registries, Treatment Failure, 030212 general & internal medicine, Survival rate, Survival analysis, Aged, Neoplasm Staging, business.industry, Cancer, Chemoradiotherapy, Chemoradiotherapy, Adjuvant, Middle Aged, Esophageal cancer, Prognosis, medicine.disease, Combined Modality Therapy, Neoadjuvant Therapy, Surgery, Cancer registry, Esophagectomy, Oncology, 030220 oncology & carcinogenesis, Female, Esophagogastric Junction, business |
| الوصف: | To date, it remains unclear whether locally advanced adenocarcinoma of the gastroesophageal junction (AEG) should be treated with neoadjuvant chemoradiation (nCRT), analogous to esophageal cancer, or with perioperative chemotherapy (pCT), analogous to gastric cancer. The purpose of this study was to analyze the data of the Munich Cancer Registry (MCR) and to compare pCT and nCRT in AEG patients. A total of 2,992 AEG patients, treated between 1998 and 2014, were included in the study. Baseline and tumor parameters as well as overall survival (OS) and tumor recurrence were compared between 56 patients undergoing nCRT and 64 patients undergoing pCT with UICC stage II/III cancer. In addition, uni- and multivariate analyses using Cox regression models were performed to evaluate the effect of tumor characteristics and treatment regimens on OS. In patients with UICC stage II/III AEG treated with either nCRT or pCT, no significant differences were seen for baseline and tumor characteristics. While there was a significantly higher cumulative incidence of locoregional treatment failure after pCT (32.8%; 95% CI: 18.0–48.4%) compared with nCRT (7.4%; 95% CI: 2.3–16.5%; p = 0.007), there was no significant difference for distant treatment failure (52.9%; 95% CI: 35.4–67.7% and 38.4%; 95% CI: 23.7–52.9%; p = 0.347). When analyzing the whole cohort, patients who received pCT were younger (58.3 years vs. 63.0 years; p = 0.016), had a higher chance of complete tumor resection (81% vs. 67%; p = 0.033), more resected lymph nodes (p = 0.036), and fewer lymph node metastases (p = 0.038) compared with patients who received nCRT. Nevertheless, there was still a strong trend toward a higher incidence of local treatment failure after pCT (25.8%; 95% CI: 14.7–38.3% vs. 12.6%; 95% CI: 5.5–22.8%; p = 0.053). Comparable to the results for patients with UICC stage II/III, no difference was seen for the incidence of distant treatment failure. When excluding patients with UICC stage IV cancer, no significant difference was found for OS. For UICC stage II/III carcinoma, nCRT was associated with an improved locoregional tumor control compared with pCT, while no further significant differences were seen between nCRT and pCT for UICC stage II/III AEG. Moreover, there was a strong trend toward improved locoregional tumor control after nCRT when analyzing all patients treated with nCRT or pCT, despite these patients having higher risk factors. |
| تدمد: | 1439-099X 0179-7158 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ecd1c6d4ddfc8b3d7f837bd771891572 https://doi.org/10.1007/s00066-017-1225-7 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....ecd1c6d4ddfc8b3d7f837bd771891572 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 1439099X 01797158 |
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