Impact of postoperative chemotherapy in patients with locally advanced gastroesophageal adenocarcinoma treated with perioperative chemotherapy strategy

Background The aim of this study was to determine the clinical impact of postoperative chemotherapy (POC) in patients with locally advanced gastroesophageal adenocarcinoma and determine the predictors of delivery of planned POC. Methods All consecutive patients with locally advanced gastroesophageal adenocarcinoma treated by perioperative chemotherapy (PCT) at our center were selected. Overall survival and disease-free survival were compared in patients who did not undergo planned POC (nondelivery of nPOC group) and patients who underwent POC (POC group). Results Among 385 patients who underwent esophagectomies or gastrectomies, PCT was performed in 110 patients. Of these, 74 (67%) patients underwent POC. Predictors of overall survival included postoperative morbidity, pT3-4 stage, R1 resection, and delivery of more than 1 cycle of POC. Factors predicting POC application included postoperative morbidity, esophagectomy, and body mass index. Conclusions Two cycles of POC were necessary to improve survival in patients with gastroesophageal adenocarcinoma.