Perioperative chemotherapy versus neoadjuvant chemoradiotherapy for esophageal or GEJ adenocarcinoma: A propensity score‐matched analysis comparing toxicity, pathologic outcome, and survival

Abstract

Compared to perioperative chemotherapy, neoadjuvant chemoradiotherapy achieves higher pathologic response rates and a lower risk of locoregional disease progression, without improving survival.

Patients with gastroesophageal junction adenocarcinomas of an advanced stage may benefit from perioperative chemoradiotherapy: A validation based on the Surveillance, Epidemiology, and End Results database

“…In the majority of previous studies, a similar prognosis was demonstrated between the PCRT and the POC groups, a finding that contradicts the results published by Tian et al Furthermore, if we focused on the patient with a T3 to T4 tumor, PCRT might have a positive influence on survival. For example, Stahl et al reported that in the Preoperative chemotherapy versus chemoradiotherapy in locally advanced adenocarcinomas of the oesophagogastric junction (POET) trial (in which only patients with T3‐T4 tumors were included), the PCRT group had a significantly improved progression‐free survival (hazard ratio [HR], 0.37; P = .01) and the overall survival (OS) also demonstrated a positive trend (HR, 0.65; P = .055).…”

Lymph node station ratio: Revised nodal category for resected esophageal squamous cell carcinoma patients

“…[19][20][21][22] The latter is particularly true for those with advanced disease that cannot be cured with surgery alone. In these patients, more emphasis should be placed on how and when to perform chemoradiation; [23][24][25][26][27][28] attempting to obtain a low LNR or SR, which may lead to excessive lymphadenectomy and further increase the incidence of postoperative complications with no demonstrable survival benefit. Therefore, these findings encourage us to explore the optimal extent of surgical resection for each tumor status via further study, and it is possible that survival could be maximized if nodal status could be predicted more precisely.…”

Examining the use of pre‐operative radiation therapy in addition to perioperative chemotherapy: National Cancer Data Base vs. Surveillance, Epidemiology, and End Results

“…Xiao et al referenced 3 studies that they argued were inconsistent with the findings of our study . In the 3 retrospective studies, the study investigators compared treatment outcomes between patients treated with neoadjuvant CRT compared with POC.…”