1. Outcomes of Neoadjuvant Chemoradiation in Patients with Gastro-esophageal Junction Adenocarcinoma: a Retrospective Cohort Study in Iran.
- Author
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Farhan F, Ghalehtaki R, Mahdavi-Seresht S, Meysamie A, Yamrali M, Farazmand B, Mohammadi N, Saraee E, Mir MR, Mir A, Lashkari M, Salarvand S, Esmati E, and Samiei F
- Subjects
- Adenocarcinoma mortality, Adenocarcinoma pathology, Adult, Aged, Aged, 80 and over, Cardia drug effects, Cardia pathology, Cardia radiation effects, Cardia surgery, Disease-Free Survival, Esophageal Mucosa drug effects, Esophageal Mucosa pathology, Esophageal Mucosa radiation effects, Esophageal Mucosa surgery, Esophageal Neoplasms mortality, Esophageal Neoplasms pathology, Esophagectomy, Esophagogastric Junction drug effects, Esophagogastric Junction pathology, Esophagogastric Junction radiation effects, Esophagogastric Junction surgery, Female, Follow-Up Studies, Gastrectomy, Gastric Mucosa drug effects, Gastric Mucosa pathology, Gastric Mucosa radiation effects, Gastric Mucosa surgery, Humans, Iran epidemiology, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local prevention & control, Neoplasm Staging, Retrospective Studies, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Survival Rate, Adenocarcinoma therapy, Chemoradiotherapy methods, Esophageal Neoplasms therapy, Neoadjuvant Therapy methods, Neoplasm Recurrence, Local epidemiology, Stomach Neoplasms therapy
- Abstract
Purpose: The optimal treatment for locally advanced GEJ and cardia adenocarcinoma is controversial. Several studies have shown that treating these patients with neoadjuvant chemoradiotherapy followed by surgery leads to survival benefits, and there are also studies that have declared conflicting results. It seems that there is still room for discussion. We calculated the survival rates and pathologic responses in our patients with characteristics which we mentioned above., Methods: Patients with locally advanced, non-metastatic GEJ and cardia adenocarcinomas (only patients with Siewert's type I and II), who were referred to Imam Khomeini hospital (Institute of cancer) between 2005 and 2014 and received neoadjuvant chemoradiation and underwent surgery were enrolled in this retrospective cohort study. Evaluations were done every 3 months., Results: Thirty-two patients enrolled in this study. Median follow up time was 23 months (Reverse Kaplan-Meier method). The rates of 1-year survival, 2-year survival, 3-year survival, 4-year survival, and 5-year survival were 75%, 52%, 52%, 37%, and 37%, respectively. No local recurrences occurred among patients; however, four patients experienced distal recurrence in the following locations: two cases (6.3%) in the liver, one case (3.1%) in the lung, and one case (3.1%) in the peritoneum. The rate of complete pathologic response (T
0 N0 ) was 21.9%., Conclusions: Neoadjuvant chemoradiation in patients with locally advanced GEJ and cardia adenocarcinoma will lead to a survival benefit.- Published
- 2019
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