| Objective The aim of the study was to evaluate the efficacy of perioperative chemotherapy in patients with locally advanced adenocarcinoma of esophagogastric junction (AEG) and to explore the main factors influencing the prognosis of these patients.
Methods Retrospective analysis was conducted on the clinical data of patients with locally advanced adenocarcinoma of the esophagogastric junction (AEG) treated at the Gastrointestinal Surgery Department of Zhejiang Cancer Hospital from January 2014 to December 2022. The patients were divided into two groups: the perioperative chemotherapy group (Group A) and the postoperative adjuvant chemotherapy group (Group B). After propensity score matching, the efficacy and prognosis of different treatment regimens were compared in these patients.
Results After PSM, a total of 200 patients were included, with 100 patients in each group(Group A and Group B). The 3-year OS rates of group A and group B were 70.70% and 72.80%, respectively (P=0.381), while the 5-year OS rates were 62.70% and 62.30%, respectively (P=0.362), with no statistically significant differences. In addition, among the overall cohort, a total of 46 patients in the both groups underwent mediastinal lymph node dissection. In these patients, the prognosis was better compared to those who did not undergo mediastinal lymph node dissection, but the difference was not statistically significant (3-year OS: 82.70% and 69.10%, P=0.086. 5-year OS: 72.30% and 61.00%, P=0.258). Multivariate analysis indicated that vascular embolus and nerve invasion were independent prognostic factors affecting survival of locally advanced AEG patients.
Conclusion Compared topostoperative adjuvant chemotherapy, perioperative chemotherapy cannot apparently prolong the survival in patients with locally advanced AEG. Besides, there was also no survival benefit from mediastinal lymph node dissected. Vascular embolus and nerve invasion possibly were the prognostic factors that affected the survival of those patients. Further prospective studies are needed to develop more rational treatment regimens.
Subject words adenocarcinoma of esophagogastric junction; perioperative chemotherapy; postoperative chemotherapy; efficacy; prognosis |
