ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2020
Survival after neoadjuvant approaches to gastroesophageal junction cancer.
Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Beyond Pathological Complete Response: Long-term Outcomes in Esophageal and Esophagogastric Junction Adenocarcinoma After Multimodal Therapy-A Systematic Review and Individual Patient-Data Meta-Analysis.Annals of surgical oncology · 2026Pooled it
- Multimodal treatments for resectable esophagogastric junction cancer: A Bayesian network meta-analysis.Langenbeck's archives of surgery · 2023Pooled it
- Survival and complications after neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for locally advanced gastric cancer: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Long-Term Postsurgical Outcomes of Neoadjuvant Chemoradiation (CROSS) Versus Chemotherapy (FLOT) for Multimodal Treatment of Adenocarcinoma of the Esophagus and the Esophagogastric Junction.Annals of surgical oncology · 2023Article
- Esophageal cancer practice guidelines 2022 edited by the Japan esophageal society: part 1.Esophagus : official journal of the Japan Esophageal Society · 2023Article
- Comparison of treatment strategies and survival of early-onset gastric cancer: a population-based study.Scientific reports · 2022Article
- Trimodality treatment in gastric and gastroesophageal junction cancers: Current approach and future perspectives.World journal of gastrointestinal oncology · 2022Review
- Prognosis after neoadjuvant chemoradiation or chemotherapy for locally advanced gastro-oesophageal junctional adenocarcinoma.The British journal of surgery · 2021Article
- Prediction of Sensitivity and Efficacy of Clinical Chemotherapy Using Larval Zebrafish Patient-Derived Xenografts of Gastric Cancer.Frontiers in cell and developmental biology · 2021Article
- Preoperative Therapy Regimen Influences the Incidence and Implication of Nodal Downstaging in Patients with Gastric Cancer.Journal of gastric cancer · 2020Article
- Advances in Treatment Models of Advanced Gastric Cancer.Technology in cancer research & treatmentReview
Corrections and comments
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4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGastroesophageal junction (GEJ) cancers can be treated with equipoise using neoadjuvant chemoradiation (NACRT) or chemotherapy alone (NAC), but the comparative outcomes are unclear.
methodsPatients with non-metastatic T2-4 or N1-3 GEJ adenocarcinoma who underwent definitive surgery and NAC or NACRT were selected from the National Cancer Database. The primary outcome was overall survival (OS). Multivariable regression and propensity score analysis were used to adjust for age, comorbidity, and other characteristics.
resultsWe identified 2435 patients treated with NACRT and 648 patients treated with NAC. OS was not significantly different between NACRT and NAC (51% versus 54% at 3 years, respectively, P = 0.11). Extent of pathological downstaging (complete, partial/mixed, none) after NACRT or NAC was highly prognostic of survival. Patients with no response did equally poorly after either preoperative regimen, and NAC was significantly less likely than NACRT to produce any response (adjusted odds ratio 0.62, P < 0.0001). Rate of adjuvant chemotherapy usage was significantly lower after NACRT than after NAC (12% versus 34%, P < 0.0001). In patients with residual tumor and nodal disease, adjuvant chemotherapy was associated with higher OS after NACRT (adjusted hazard ratio 0.81, P = 0.05), but not after NAC. These results were further validated by propensity score analysis.
conclusionsNACRT had similar survival to NAC despite superior pathological downstaging. Adjuvant chemotherapy is relatively underused after NACRT and warrants further study as a risk-adapted means to improve survival, especially in patients with larger burden of residual disease.
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