Esophagogastric junction adenocarcinoma: Preoperative chemoradiation or perioperative chemotherapy?

Laxague, Francisco; Schlottmann, Francisco

doi:10.5306/wjco.v12.i7.557

Cited by 6 publications

(2 citation statements)

References 25 publications

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“…Neoadjuvant therapy has been shown to improve the prognosis of AEG patients by reducing the clinical stage of the tumor and increasing the rate of radical surgical resection. According to the current study, both methods of neoadjuvant therapy appear to have comparable survival benefits ( 7 ).…”

Section: Introductionmentioning

confidence: 68%

Nomograms for Predicting Disease-Free Survival in Patients With Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction Receiving Neoadjuvant Therapy and Radical Surgery

Guo

Tian

et al. 2022

Front. Oncol.

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ObjectiveThis study aimed to develop prognostic prediction models for patients with Siewert type II/III adenocarcinoma of the esophagogastric junction (AEG) who received neoadjuvant therapy (neoadjuvant chemoradiotherapy or neoadjuvant chemotherapy) and radical surgery. A baseline nomogram and a post-operative nomogram were constructed before neoadjuvant therapy and after surgery. The predictive performance of the constructed nomograms was internally validated and compared to the TNM staging system.Materials and MethodsA total of 245 patients diagnosed with Siewert type II/III AEG and treated with neoadjuvant therapy followed by radical surgery at The Fourth Hospital of Hebei Medical University between January 2011 and December 2017 were enrolled. The variables before neoadjuvant therapy were defined as baseline factors, while the variables of baseline factors along with the variables of treatment and postoperative pathology were defined as post-operative factors. To construct the corresponding nomograms, independent predictors of baseline and post-operative factors were identified. The C-index and a time-dependent receiver operating characteristic curve were used to evaluate the model’s discrimination ability. The calibration ability of the model was determined by comparing the probability of predicted free-recurrence to the actual free-recurrence. Decision curve analysis (DCA) was used to determine the clinical usefulness of the nomogram.ResultsAmong the baseline factors, age, cT stage, cN stage, Borrmann type, and staging laparoscopy were independent prognostic predictors. In contrast, among the post-operative factors, age, cN stage, staging laparoscopy, ypT stage, clinical response, number of positive lymph nodes, number of negative lymph nodes, laurén classification, and lymphatic, or perineural invasion (VELPI) were independent prognostic predictors. The two nomograms were constructed using the independent predictors of prognosis. The C-indexes for the baseline and post-operative nomograms were 0.690 (95% CI, 0.644-0.736) and 0.817 (95% CI, 0.782-0.853), respectively. The AUCs of the baseline nomogram at 3 and 5 years were both greater than cTNM (73.1 vs 58.8, 76.1 vs 55.7). Similarly, the AUCs of the post-operative nomogram were both greater than ypTNM (85.2 vs 69.1, 88.2 vs 71.3) at 3 and 5 years. The calibration curves indicated that both models had a high degree of calibration ability. By comparing the DCA at 3 and 5 years, we determined that the two nomograms constructed had better clinical utility than the TNM staging system.ConclusionsThe constructed nomograms have a more accurate predictive ability than the eighth edition TNM staging system, which can be useful for treatment selection and follow-up monitoring of patients.

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Section: Introductionmentioning

confidence: 68%

Nomograms for Predicting Disease-Free Survival in Patients With Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction Receiving Neoadjuvant Therapy and Radical Surgery

Guo

Tian

et al. 2022

Front. Oncol.

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“…ey also used different staging patterns for TNM to treat different patients [2]. e study of Laxague et al pointed out that neoadjuvant chemotherapy is a way to shrink the tumor and remove tumor cells to treat esophagogastric junction cancer [3]. Minami et al performed preoperative TN staging for patients.…”

Section: Introductionmentioning

confidence: 99%

[Retracted] Clinical Comparison of Endoscopic Ultrasonography and CT in Preoperative TN Staging of Esophagogastric Junction Cancer

Peng

Lou

Wang

et al. 2022

Contrast Media & Molecular Imaging

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In recent years, the incidence of esophagogastric junction cancer has increased year by year. It is a special type of gastric cancer, with 80% of patients being clinically in the middle and late stages. The traditional treatment methods are extremely ineffective, and the accuracy of preoperative staging is not good enough. At present, the medical treatment for esophagogastric junction cancer mainly adopts surgery and postoperative adjuvant therapy. The current mainstream clinical diagnostic methods of esophagogastric junction cancer before concurrent neoadjuvant chemoradiotherapy are X-ray, CT examination, and gastroscopic diagnosis. However, these clinical diagnostic methods have many limitations. Endoscopic ultrasonography (EUS) can accurately locate malignant tumors in the digestive tract, surrounding microstructures. It can diagnose lymphatic metastasis so as to provide a clear imaging basis for neoadjuvant chemoradiotherapy. This method can also effectively improve the prognosis of the esophagus and stomach according to the characteristics of the patient. In this experiment, we conducted a controlled trial on patients with stage III esophagogastric junction cancer, divided into an experimental group (neoadjuvant chemotherapy + surgery) and a control group (conventional surgery). The preoperative EUS staging in the control group, the preoperative EUS staging in the neoadjuvant chemoradiotherapy group, and the postoperative pathological staging were compared. The experiment showed that in the control group, the preoperative and postoperative accuracy of EUS was 89.2%, while the preoperative and postoperative accuracy of CT examination was only 62.5%. In the experimental group, the preoperative and postoperative accuracies of EUS and CT were 79.6% and 56.7%, respectively. EUS has both specificity and accuracy due to CT examination. Through studying EUS technology in the staging and diagnosis of esophagogastric junction cancer, the therapeutic effect of esophagogastric junction cancer can be improved. The prognosis of esophagogastric junction cancer can also be improved.

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An Overview of Essential Oil Anticancer Activity

Silva

Ramos

Matos³

et al. 2022

Essential Oils

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Esophagogastric junction adenocarcinoma: Preoperative chemoradiation or perioperative chemotherapy?

Cited by 6 publications

References 25 publications

Nomograms for Predicting Disease-Free Survival in Patients With Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction Receiving Neoadjuvant Therapy and Radical Surgery

Nomograms for Predicting Disease-Free Survival in Patients With Siewert Type II/III Adenocarcinoma of the Esophagogastric Junction Receiving Neoadjuvant Therapy and Radical Surgery

[Retracted] Clinical Comparison of Endoscopic Ultrasonography and CT in Preoperative TN Staging of Esophagogastric Junction Cancer

An Overview of Essential Oil Anticancer Activity

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