Gastroesophageal adenocarcinoma patients benefit from adjuvant chemotherapy
Improved overall survival was seen for adjuvant chemotherapy vs postoperative observation.
(HealthDay News) — Adjuvant chemotherapy is associated with improved survival for patients with locally-advanced gastroesophageal adenocarcinoma treated with preoperative chemoradiotherapy and resection, according to a study published online Sept. 21 in JAMA Oncology.
Ali A. Mokdad, MD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues compared adjuvant chemotherapy with postoperative observation following preoperative chemoradiotherapy and resection. Participants were adult patients who received a diagnosis of clinical stage T1N1-3M0 or T2-4N0-3M0 adenocarcinoma of the distal esophagus or gastric cardia. A total of 10,086 patients were identified: 9,272 in the postoperative observation group and 814 in the adjuvant chemotherapy group.
The researchers found that patients receiving adjuvant chemotherapy were younger, more likely to have advanced disease, and had shorter postoperative inpatient stays. In a cohort of 732 patients in the adjuvant chemotherapy group and 3,660 propensity-score matched patients in the postoperative observation group, improved overall survival was seen for adjuvant chemotherapy vs postoperative observation (median survival, 40 vs 34 months; hazard ratio, 0.79). At one, three, and five years, overall survival was 88%, 47%, and 34% and 94%, 54%, and 38% in the observation and adjuvant chemotherapy groups, respectively. In most patient subgroups, adjuvant chemotherapy correlated with a survival benefit compared with postoperative observation.
"Our findings have important implications for the postoperative treatment of this patient group for which few data are available," the authors write.
Mokdad AA, Yopp AC, Polanco PM, et al. Adjuvant chemotherapy vs postoperative observation following preoperative chemoradiotherapy and resection in gastroesophageal cancer: A propensity score-matched analysis. JAMA Oncol. 2017 Sep 21. doi: 10.1001/jamaoncol.2017.2805