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Multicenter Study
. 2022 Mar 14;29(3):1983-1996.
doi: 10.3390/curroncol29030161.

Impact of Postoperative Chemotherapy in Patients with Gastric/Gastroesophageal Adenocarcinoma Treated with Perioperative Chemotherapy

Alexej Ballhausen  1 , Prisca Bartels  1 , Ines Iacovella  1 , Anica Hoegner  1 , Alessandro Lorusso  1 , Dmitry Bichev  2 , Severin Daum  3 , Peter Thuss-Patience  1
Affiliations
Multicenter Study

Impact of Postoperative Chemotherapy in Patients with Gastric/Gastroesophageal Adenocarcinoma Treated with Perioperative Chemotherapy

Alexej Ballhausen et al. Curr Oncol. .

Abstract

Perioperative chemotherapy is the standard of care for patients undergoing curative resection for gastroesophageal adenocarcinoma. However, less than 50% of patients complete postoperative chemotherapy, and the added benefit to preoperative chemotherapy remains unclear. The aim of this study was to compare disease-free and overall survival (DFS and OS) in patients with perioperative chemotherapy to those who received preoperative chemotherapy only. In addition, a current literature overview is included. This multicenter, retrospective case series included 124 patients with gastroesophageal adenocarcinoma undergoing potentially curative resection and receiving pre- or perioperative chemotherapy between 2006 and 2010. Histopathological, demographic, clinical, and survival data were used to identify the impact of perioperative vs. preoperative chemotherapy on DFS and OS. Patients with perioperative chemotherapy had significantly improved DFS and OS (median DFS 28.0 months; 95%CI 0-62.4 vs. 19.0 months; 95%CI 10.5-27.5; p = 0.008 and median OS 35.7 months; 95%CI 0-73.6 vs. 19.2 months; 95%CI 7.8-30.4; p = 0.002). However, in contrast to patients with tumor-free lymph nodes at the time of resection, patients with positive lymph node status did not significantly benefit from additional postoperative chemotherapy in subgroup analysis. Further studies are encouraged to investigate optimal adjuvant treatment strategies for primary chemotherapy-resistant patients.

Keywords: gastroesophageal cancer; perioperative chemotherapy; postoperative chemotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CONSORT flow diagram.
Figure 2
Figure 2
(A) Disease-free and (B) overall survival for patients receiving perioperative (periCTx, blue line) and preoperative chemotherapy (preCTx, green line) is displayed.
Figure 3
Figure 3
Tumor-specific overall survival for patients receiving perioperative (periCTx, blue line) or preoperative chemotherapy (preCTx, green line).
Figure 4
Figure 4
(A) Disease-free and (B) overall survival by completeness of postoperative chemotherapy (postCTx). Full postCTx status is represented by blue lines. Green lines represent incomplete postCTx status.
Figure 5
Figure 5
Disease-free (DFS) and overall survival (OS) by nodal status at baseline (DFS (A); OS (B)) and by at time of resection (DFS (C); OS (D)). Negative nodal status is represented by blue lines. Green lines represent positive nodal status. Survival of patients receiving preoperative chemotherapy (preCTx) is marked by dashed lines.
See this image and copyright information in PMC

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