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Pathologic nodal status predicts disease-free survival after neoadjuvant chemoradiation for gastroesophageal junction carcinoma.

Publication ,  Journal Article
Gaca, JG; Petersen, RP; Peterson, BL; Harpole, DH; D'Amico, TA; Pappas, TN; Seigler, HF; Wolfe, WG; Tyler, DS
Published in: Ann Surg Oncol
March 2006

BACKGROUND: The incidence of carcinoma of the gastroesophageal junction (GEJ) is rapidly increasing, and the prognosis remains poor. We examined outcomes in patients who received neoadjuvant chemoradiation for GEJ tumors to identify factors that predict disease-free (DFS) and overall (OS) survival. METHODS: A retrospective analysis was performed of 101 consecutive patients who received chemoradiation and surgery for GEJ carcinoma between 1992 and 2001. RESULTS: The median DFS and OS of all patients were 16 and 25 months, respectively. Twenty-eight patients with a complete histological response (T0N0) experienced greater DFS compared with all others (P = .02). Node-negative patients, regardless of T stage, experienced improved median DFS (24 months) compared with N1 patients (9 months; P = .01). Preoperative stage, age, tumor location, or Barrett's esophagus did not independently predict OS by univariate analysis. Multivariate analysis demonstrated that only posttreatment nodal status (P = .03)-not the degree of primary tumor response-predicted DFS. CONCLUSIONS: The nodal status of patients with GEJ tumors after neoadjuvant therapy is predictive of DFS after resection. The poor outcome in node-positive patients supports postneoadjuvant therapy nodal staging, because surgical aggressiveness should be tempered by the realization that cure is unlikely and median survival is short.

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Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

March 2006

Volume

13

Issue

3

Start / End Page

340 / 346

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stomach Neoplasms
  • Retrospective Studies
  • Predictive Value of Tests
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Humans
 

Citation

APA
Chicago
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MLA
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Gaca, J. G., Petersen, R. P., Peterson, B. L., Harpole, D. H., D’Amico, T. A., Pappas, T. N., … Tyler, D. S. (2006). Pathologic nodal status predicts disease-free survival after neoadjuvant chemoradiation for gastroesophageal junction carcinoma. Ann Surg Oncol, 13(3), 340–346. https://doi.org/10.1245/ASO.2006.02.023
Gaca, Jeffrey G., Rebecca P. Petersen, Bercedis L. Peterson, David H. Harpole, Thomas A. D’Amico, Theodore N. Pappas, Hilliard F. Seigler, Walter G. Wolfe, and Douglas S. Tyler. “Pathologic nodal status predicts disease-free survival after neoadjuvant chemoradiation for gastroesophageal junction carcinoma.Ann Surg Oncol 13, no. 3 (March 2006): 340–46. https://doi.org/10.1245/ASO.2006.02.023.
Gaca JG, Petersen RP, Peterson BL, Harpole DH, D’Amico TA, Pappas TN, et al. Pathologic nodal status predicts disease-free survival after neoadjuvant chemoradiation for gastroesophageal junction carcinoma. Ann Surg Oncol. 2006 Mar;13(3):340–6.
Gaca, Jeffrey G., et al. “Pathologic nodal status predicts disease-free survival after neoadjuvant chemoradiation for gastroesophageal junction carcinoma.Ann Surg Oncol, vol. 13, no. 3, Mar. 2006, pp. 340–46. Pubmed, doi:10.1245/ASO.2006.02.023.
Gaca JG, Petersen RP, Peterson BL, Harpole DH, D’Amico TA, Pappas TN, Seigler HF, Wolfe WG, Tyler DS. Pathologic nodal status predicts disease-free survival after neoadjuvant chemoradiation for gastroesophageal junction carcinoma. Ann Surg Oncol. 2006 Mar;13(3):340–346.
Journal cover image

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

March 2006

Volume

13

Issue

3

Start / End Page

340 / 346

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Stomach Neoplasms
  • Retrospective Studies
  • Predictive Value of Tests
  • Oncology & Carcinogenesis
  • Neoadjuvant Therapy
  • Middle Aged
  • Male
  • Lymphatic Metastasis
  • Humans