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©The Author(s) 2022.
World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1540-1551
Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1540
Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1540
Table 1 Clinicopathological features of all patients
Variable | Overall | Adjuvant chemoradiotherapy group | Adjuvant chemotherapy group |
316 | 57 | 259 | |
Age, n (%) | |||
< 40 yr | 6 (1.9) | 2 (3.5) | 4 (1.5) |
≥ 40 yr | 310 (98.1) | 55 (96.5) | 255 (98.5) |
Sex, n (%) | |||
Male | 268 (84.8) | 46 (80.7) | 222 (85.7) |
Female | 48 (15.2) | 11 (19.3) | 37 (14.3) |
BMI, n (%) | |||
< 18.5 or > 23.9 | 169 (53.5) | 27 (47.4) | 142 (54.8) |
18.5-23.9 | 147 (46.5) | 30 (52.6) | 117 (45.2) |
The degree of differentiation, n (%) | |||
Poorly differentiated | 233 (73.7) | 45 (78.9) | 188 (72.6) |
Moderately-highly differentiated | 83 (26.3) | 12 (21.1) | 71 (27.4) |
Nerve invasion, n (%) | |||
Yes | 269 (85.1) | 43 (75.4) | 226 (87.3) |
No | 47 (14.9) | 14 (24.6) | 33 (12.7) |
Vascular invasion, n (%) | |||
Yes | 263 (83.2) | 40 (70.2) | 223 (86.1) |
No | 53 (16.8) | 17 (29.8) | 36 (13.9) |
Pathologic T stage, n (%) | |||
pT1-3 | 179 (56.6) | 34 (59.6) | 145 (56.0) |
pT4a-4b | 137 (43.4) | 23 (40.4) | 114 (44.0) |
Pathologic N stage, n (%) | |||
pN1-2 | 73 (23.1) | 10 (17.5) | 63 (24.3) |
PN3 | 243 (76.9) | 47 (82.5) | 196 (75.7) |
Pathological stage, Siewert type II | 148 (46.8) | 25 (43.9) | 123 (47.5) |
IIIB stage | 30 (9.5) | 6 (10.5) | 24 (9.3) |
IVA stage | 118 (37.3) | 19 (33.3) | 99 (38.2) |
Pathological stage, Siewert type III | 168 (53.2) | 32 (56.1) | 136 (52.5) |
IIIA | 32 (10.1) | 1 (1.8) | 31 (12.0) |
IIIB | 80 (25.3) | 22 (38.6) | 58 (22.4) |
IIIC | 56 (17.7) | 9 (15.8) | 47 (18.1) |
Table 2 5-year survival rate in adjuvant chemoradiotherapy group and adjuvant chemotherapy group
Group | N | 5-yr survival rate (%) | Log rank test | |
OS | All patietnts | P = 0.010 | ||
Adjuvant chemoradiotherapy group | 57 | 66.7 | ||
Adjuvant chemotherapy group | 295 | 41.9 | ||
RFS | All patietnts | P = 0.254 | ||
Adjuvant chemoradiotherapy group | 52 | 64.5 | ||
Adjuvant chemotherapy group | 128 | 55.3 | ||
OS | Siewert type II | P = 0.063 | ||
Adjuvant chemoradiotherapy group | 25 | 59.3 | ||
Adjuvant chemotherapy group | 123 | 39.4 | ||
RFS | Siewert type II | P = 0.995 | ||
Adjuvant chemoradiotherapy group | 22 | 60.5 | ||
Adjuvant chemotherapy group | 58 | 55.9 | ||
OS | Siewert type III | P = 0.006 | ||
Adjuvant chemoradiotherapy group | 32 | 65.7 | ||
Adjuvant chemotherapy group | 136 | 43.9 | ||
RFS | Siewert type III | P = 0.082 | ||
Adjuvant chemoradiotherapy group | 30 | 72.6 | ||
Adjuvant chemotherapy group | 70 | 56.8 |
Table 3 Distributions of recurrence in Adjuvant chemoradiotherapy group and adjuvant chemotherapy group
Recurrence site | Adjuvant chemoradiotherapy group | Adjuvant chemotherapy group | ||
No. of patients | % of recurrence patients (n = 18) | No. of patients | % of recurrence patients (n = 61) | |
Local recurrence, n (%) | ||||
Remnant stomach | 1 | 5.6 | 1 | 1.6 |
Anastomosis site | 3 | 16.7 | 14 | 23.0 |
Regional recurrence | 5 | 27.8 | 24 | 39.3 |
Distant metastasis, n (%) | ||||
One site | ||||
Peritoneum | 5 | 27.8 | 8 | 13.1 |
Pleura | 2 | 11.1 | 4 | 6.6 |
Solid organ | 4 | 22.2 | 16 | 26.2 |
Distant LNs | 2 | 11.1 | 5 | 8.2 |
Bone metastases | 2 | 11.1 | 3 | 4.9 |
≥ 2 sites | ||||
Peritoneum + solid organ | 2 | 11.1 | 3 | 4.9 |
Solid organs | 1 | 5.6 | 2 | 3.3 |
Peritoneum + distant LNs | 0 | 0 | 1 | 1.6 |
Solid organs + distant LNs | 0 | 0 | 1 | 1.6 |
Table 4 Univariate and multivariable cox proportional hazards modeling for overall survival in Siewert type II gastroesophageal junction
Clinicopathological features | Univariate analysis | Multivariable analysis | ||
HR (95%CI) | P value | HR (95%CI) | P value | |
Sex | ||||
Male | Ref. | |||
Female | 0.683 (0.389-1.199) | P = 0.185 | ||
BMI | ||||
18.5-23.9 | Ref. | |||
< 18.5 or > 23.9 | 1.019 (0.657-1.581) | P = 0.931 | ||
The degree of differentiation | ||||
Poorly differentiated | Ref. | |||
Moderately-highly differentiated | 0.733 (0.437-1.227) | P = 0.237 | ||
Nerve invasion | ||||
Yes | Ref. | Ref. | ||
No | 0.083 (0.020-0.339) | P = 0.001 | 0.117 (0.028-0.500) | P = 0.004 |
Vascular invasion | ||||
Yes | Ref. | Ref. | ||
No | 0.215 (0.093-0.496) | P < 0.001 | 0.425 (0.178-1.014) | P = 0.054 |
Pathologic T stage | ||||
Group 1-3 | Ref. | Ref. | ||
Group 4a-4b | 1.404 (0.899-2.194) | P = 0.136 | 1.271 (0.777-2.080) | P = 0.340 |
Pathologic N stage | ||||
Group 1-2 | Ref. | Ref. | ||
Group 3a-b | 2.089 (1.137-3.721) | P = 0.012 | 1.027 (0.385-2.739) | P = 0.958 |
Pathologic TNM stage | ||||
IIIB stage | Ref. | Ref. | ||
IVA stage | 2.540 (1.267-5.091) | P = 0.009 | 2.081 (0.629-6.885) | P = 0.230 |
Adjuvant chemoradiotherapy | ||||
Yes | Ref. | Ref. | ||
No | 1.859 (0.956-3.614) | P = 0.068 | 1.877 (0.943-3.738) | P = 0.073 |
Table 5 Univariate and multivariable cox proportional hazards modeling for overall survival in Siewert type III gastroesophageal junction
Clinicopathological features | Univariate analysis | Multivariable analysis | ||
HR (95%CI) | P value | HR (95%CI) | P value | |
Sex | ||||
Male | Ref. | |||
Female | 0.573 (0.277-1.186) | P = 0.134 | ||
BMI | ||||
18.5-23.9 | Ref. | |||
< 18.5 or > 23.9 | 1.142 (0.755-1.728) | P = 0.530 | ||
The degree of differentiation | ||||
Poorly differentiated | Ref. | |||
Moderately-highly differentiated | 0.945 (0.592-1.509) | P = 0.813 | ||
Nerve invasion | ||||
Yes | Ref. | Ref. | ||
No | 0.086 (0.021-0.349) | P = 0.001 | 0.169 (0.037-0.774) | P = 0.022 |
Vascular invasion | ||||
Yes | Ref. | Ref. | ||
No | 0.041 (0.006-0.295) | P = 0.002 | 0.092 (0.012-0.689) | P = 0.020 |
Pathologic T stage | ||||
Group 1-3 | Ref. | Ref. | ||
Group 4a-4b | 1.479 (0.975-2.242) | P = 0.065 | 1.151 (0.751-1.763) | P = 0.518 |
Pathologic N stage | ||||
Group 1-2 | Ref. | Ref. | ||
Group 3 | 1.983 (1.099-3.580) | P = 0.023 | 3.621 (0.380-34.469) | P = 0.263 |
Pathologic TNM stage | ||||
IIIA stage | Ref. | Ref. | ||
IIIB stage | 1.420 (0.759-2.656) | P = 0.273 | 1.801 (0.180-18.037) | P = 0.617 |
IIIC stage | 2.783 (1.472-5.261) | P = 0.002 | 0.681 (0.434-1.069) | P = 0.095 |
Adjuvant chemoradiotherapy | ||||
Yes | Ref. | Ref. | ||
No | 2.465 (1.270-4.782) | P = 0.008 | 2.258 (1.145-4.453) | P = 0.019 |
- Citation: Kang WZ, Shi JM, Wang BZ, Xiong JP, Shao XX, Hu HT, Jin J, Tian YT. Adjuvant chemoradiotherapy vs adjuvant chemotherapy in locally advanced Siewert type II/III adenocarcinoma of gastroesophageal junction after D2/R0 resection. World J Gastrointest Oncol 2022; 14(8): 1540-1551
- URL: https://www.wjgnet.com/1948-5204/full/v14/i8/1540.htm
- DOI: https://dx.doi.org/10.4251/wjgo.v14.i8.1540