Neoadjuvant Vs. Adjuvant Treatment of Siewert Type II Gastroesophageal Junction Cancer: an Analysis of Data from the Surveillance, Epidemiology, and End Results (SEER) Registry

Overview

Journal J Gastrointest Oncol

Date 2016 Jun 11

PMID 27284473

Citations 15

Authors

Joseph A Miccio

Oluwadamilola T Oladeru

Jie Yang

Yaqi Xue

Minsig Choi

Yue Zhang

Hannah Yoon

Samuel Ryu

Alexander M Stessin

Affiliations

Soon will be listed here.

Abstract

Background: Cancer of the gastroesophageal junction (GEJ) has been rising in incidence in recent years. The role of radiation therapy (RT) in the treatment of GEJ cancer remains unclear, as the largest prospective trials advocating for either adjuvant or neoadjuvant chemoradiotherapy (CRT) combine GEJ cancer with either gastric or esophageal cancer. The aim of the present study is to examine the association of neoadjuvant versus adjuvant treatment with overall and disease-specific survival (DSS) for patients with surgically resected cancer of the true GEJ (Siewert type II).

Methods: The surveillance, epidemiology, and end results (SEER) registry database (2001-2011) was queried for cases of surgically resected Siewert type II GEJ cancer. A total of 1,497 patients with resectable GEJ cancer were identified, with 746 receiving adjuvant RT and 751 receiving neoadjuvant RT. Retrospective analysis was performed with the endpoints of overall and DSS.

Results: Using cox regression and controlling for independent covariates (age, sex, race, stage, grade, histology, and year of diagnosis), we showed that adjuvant RT was associated with a significantly lower death risk [hazard ratio (HR), 0.84; 95% confidence interval 0.73-0.97; P value=0.0168] and significantly lower disease-specific death risk (HR, 0.84; 95% confidence interval, 0.72-0.97; P value=0.0211) as compared to neoadjuvant RT.

Conclusions: This analysis of SEER data showed that adjuvant RT was associated with a survival benefit as compared to neoadjuvant RT for the treatment of Siewert type II GEJ cancer. We suggest future prospective studies to compare outcomes of adjuvant versus neoadjuvant treatment for true GEJ cancer.

Citing Articles

The Impact of Diagnostic Laparoscopy on Upstaging Patients with Siewert II and III Gastroesophageal Junction (GEJ) Cancer.

Alcasid N, Fink D, Banks K, Susai C, Barnes K, Wile R Ann Surg Oncol. 2024; 32(1):258-264.

PMID: 39503948 PMC: 11659370. DOI: 10.1245/s10434-024-15862-0.

Time to Discard the Staging Laparoscopy? Elucidating the Role for Routine Diagnostic Laparoscopy in Patients with Gastroesophageal Junction Malignancy.

Florea I, Hong Y Ann Surg Oncol. 2024; 32(1):27-29.

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Development of a novel staging classification for Siewert II adenocarcinoma of the esophagogastric junction after neoadjuvant chemotherapy.

Zhang J, Liu H, Yu H, Xu W World J Gastrointest Oncol. 2024; 16(6):2541-2554.

PMID: 38994140 PMC: 11236254. DOI: 10.4251/wjgo.v16.i6.2541.

The development and validation of automated machine learning models for predicting lymph node metastasis in Siewert type II T1 adenocarcinoma of the esophagogastric junction.

Lu C, Liu L, Yin M, Lin J, Zhu S, Gao J Front Med (Lausanne). 2024; 11:1266278.

PMID: 38633305 PMC: 11021582. DOI: 10.3389/fmed.2024.1266278.

Marital Status Is a Prognostic Factor for Cardiovascular Mortality but Not a Prognostic Factor for Cancer Mortality in Siewert Type II Adenocarcinoma of the Esophagogastric Junction.

Zheng Z, Sun X Gastroenterology Res. 2024; 16(6):307-317.

PMID: 38186587 PMC: 10769607. DOI: 10.14740/gr1670.

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