Ge X, et al. - Retrospective analysis was performed to assess whether preoperative chemoradiotherapy (CRT) could improve the prognosis of patients with locally advanced Siewert II and III esophagogastric junction (AEG) comparing with preoperative chemotherapy alone (CT). The addition of radiotherapy to preoperative chemotherapy could improve survival with safety for the patients with locally advanced AEG. However, it was not an independent prognostic factor for overall survival (OS) and PFS.

Methods

• Researchers identified 170 patients with locally advanced (cT3-4NxM0) Siewert II and III AEG who were treated with preoperative CRT or CT in Hebei Medical University Fourth Hospital from March 2012 to December 2015.
• They included 123 patients to compare the effects of preoperative CRT with CT.

Results

• In CRT group, R0 resection rate was 96.7% compared to 82.5% in CT group (P=0.016).
• Researchers observed the pathological complete response of 16.7% and 3.2% after CRT and CT, respectively (P=0.015).
• For a median period of 20 months, patients were followed.
• In CRT group, the 1- and 3-year OS were 89.4%, 79.2% and in CT group, the respective values were 88.2%, 58.0% (P=0.016; HR=0.40, 95% confidence interval 0.21–0.76).
• In CRT group the 1- and 3-year PFS were 87.3%, 73.5% and in CT group, the respective values were 72.8%, 42.8% (P=0.014; HR=0.46, 95% confidence interval 0.24-0.86).
• In multivariate analysis, they recognized that clinical T stage, adjuvant chemotherapy cycles and histologic differentiation were the independent prognostic factors for OS, and postoperative pathologic N stage was the independent prognostic factor for PFS.