Farhan Farshid, Ghalehtaki Reza, Mahdavi-Seresht Shiva, Meysamie Alipasha, Yamrali Maisa, Farazmand Borna, Mohammadi Negin, Saraee Ehsan, Mir Mohammad-Reza, Mir Ali, Lashkari Marzieh, Salarvand Samaneh, Esmati Ebrahim, Samiei Farhad
Department of Radiation Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Gastrointest Cancer. 2019 Dec;50(4):907-912. doi: 10.1007/s12029-018-0155-7.
The optimal treatment for locally advanced GEJ and cardia adenocarcinoma is controversial. Several studies have shown that treating these patients with neoadjuvant chemoradiotherapy followed by surgery leads to survival benefits, and there are also studies that have declared conflicting results. It seems that there is still room for discussion. We calculated the survival rates and pathologic responses in our patients with characteristics which we mentioned above.
Patients with locally advanced, non-metastatic GEJ and cardia adenocarcinomas (only patients with Siewert's type I and II), who were referred to Imam Khomeini hospital (Institute of cancer) between 2005 and 2014 and received neoadjuvant chemoradiation and underwent surgery were enrolled in this retrospective cohort study. Evaluations were done every 3 months.
Thirty-two patients enrolled in this study. Median follow up time was 23 months (Reverse Kaplan-Meier method). The rates of 1-year survival, 2-year survival, 3-year survival, 4-year survival, and 5-year survival were 75%, 52%, 52%, 37%, and 37%, respectively. No local recurrences occurred among patients; however, four patients experienced distal recurrence in the following locations: two cases (6.3%) in the liver, one case (3.1%) in the lung, and one case (3.1%) in the peritoneum. The rate of complete pathologic response (TN) was 21.9%.
Neoadjuvant chemoradiation in patients with locally advanced GEJ and cardia adenocarcinoma will lead to a survival benefit.
局部晚期胃食管交界部和贲门腺癌的最佳治疗方案存在争议。多项研究表明，对这些患者采用新辅助放化疗后再进行手术可带来生存获益，但也有研究得出了相互矛盾的结果。似乎仍有讨论的空间。我们计算了具有上述特征的患者的生存率和病理反应。
对2005年至2014年间转诊至伊玛目霍梅尼医院（癌症研究所）、接受新辅助放化疗并接受手术的局部晚期、非转移性胃食管交界部和贲门腺癌患者（仅Siewert I型和II型患者）进行了这项回顾性队列研究。每3个月进行一次评估。
本研究共纳入32例患者。中位随访时间为23个月（反向Kaplan-Meier法）。1年生存率、2年生存率、3年生存率、4年生存率和5年生存率分别为75%、52%、52%、37%和37%。患者中未发生局部复发；然而，4例患者在以下部位出现远处复发：肝脏2例（6.3%）、肺1例（3.1%）、腹膜1例（3.1%）。完全病理缓解率（TN）为21.9%。
局部晚期胃食管交界部和贲门腺癌患者接受新辅助放化疗可带来生存获益。
