Impact of postoperative chemotherapy in patients with locally advanced gastroesophageal adenocarcinoma treated with perioperative chemotherapy strategy

Am J Surg. 2015 Jul;210(1):15-23. doi: 10.1016/j.amjsurg.2014.12.036. Epub 2015 Mar 28.

Abstract

Background: The aim of this study was to determine the clinical impact of postoperative chemotherapy (POC) in patients with locally advanced gastroesophageal adenocarcinoma and determine the predictors of delivery of planned POC.

Methods: All consecutive patients with locally advanced gastroesophageal adenocarcinoma treated by perioperative chemotherapy (PCT) at our center were selected. Overall survival and disease-free survival were compared in patients who did not undergo planned POC (nondelivery of nPOC group) and patients who underwent POC (POC group).

Results: Among 385 patients who underwent esophagectomies or gastrectomies, PCT was performed in 110 patients. Of these, 74 (67%) patients underwent POC. Predictors of overall survival included postoperative morbidity, pT3-4 stage, R1 resection, and delivery of more than 1 cycle of POC. Factors predicting POC application included postoperative morbidity, esophagectomy, and body mass index.

Conclusions: Two cycles of POC were necessary to improve survival in patients with gastroesophageal adenocarcinoma.

Keywords: Gastroesophageal adenocarcinoma; Perioperative chemotherapy; Postoperative chemotherapy.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Chemotherapy, Adjuvant
  • Esophageal Neoplasms / drug therapy*
  • Esophageal Neoplasms / surgery*
  • Esophagectomy*
  • Esophagogastric Junction*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Postoperative Care
  • Retrospective Studies
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / surgery*
  • Young Adult