5PSQ-026 Comparison of perioperative chemotherapy and preoperative chemoradiotherapy in gastroesophageal junction adenocarcinoma: analysis from the AGAMENON-SEOM registry
Year: 2025
Type: conference-paper
Study design: Observational Study
Abstract: Background and Importance The optimal curative strategy for gastroesophageal junction adenocarcinoma (GEJA) is unknown. Aim and Objectives This study compares perioperative chemotherapy (CT) with preoperative chemoradiotherapy (CRT) in GEJA treatment. Material and Methods From the AGAMENON-SEOM registry, 1893 patients had localised gastroesophageal adenocarcinoma, and of those, the ones with GEJA who were treated with preoperative CRT or perioperative CT were included. Results Among the 285 GEJA patients diagnosed between 2009 and 2023, 77% (n=220) received perioperative CT, and 23% (n=65) received preoperative CRT. The median age was 64 years (range 34–91), 20% (n=57) were women, and 95% (n=271) had an ECOG performance status of 0–1. Patient characteristics and outcomes are summarised in table 1. Siewert III cancers were more common in the perioperative CT group (34%), while Siewert I cancers predominated in the CRT group (41%). Surgery was performed in 92% of CT-treated and 85% of CRT-treated patients, with R0 resection rates of 78% and 79% and complete pathological responses of 9% and 16%, respectively. Four percent did not complete preoperative CRT, while 32% did not start postoperative CT. Recurrence occurred in 31% of patients treated with perioperative CT and 36% with CRT. Recurrence patterns for perioperative CT were distant (19%), local (7%), and mixed (5%), while for CRT were distant (29%), local (0%), and mixed (7%). Distant recurrence was more frequent with CRT (p<0.005). Severe postoperative complications occurred in 15%, and lethal complications in 4%, with no differences between treatments. Overall survival was 53 vs. 41 months (HR 0.77; 0.72–0.90; p=0.043) and disease-free survival was 34 vs. 29 months (HR 0.85; 0.83–1.15; p=0.661) for CT vs. CRT. Conclusion and Relevance For GEJA T2–4 or N+ M0, perioperative CT was associated with fewer distant metastases and improved overall survival compared to neoadjuvant CRT. References and/or Acknowledgements Conflict of Interest No conflict of interest
Authors: L Macía-Rivas, L Mateos-Rueda, I De La Fuente Villaverde, S Fernández-Lastras, L Oyague-López, A Martínez-Torrón, JL Catoya Villa, A Francisco Fernández, C Sáenz De Jubera, P Jiménez-Fonseca, FJ Álvarez-Manceñido
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4408377144