Benefit of Neoadjuvant Chemotherapy for Siewert Type II Esophagogastric Junction XXXX .

@entity1 @entity900 @entity420 @entity1205
AIM: Our objective was to clarify if preoperative chemotherapy was associated with improved survival in Japanese @entity1 with Siewert type II @entity420 . @entity1 AND METHODS: We retrospectively reviewed the medical records of 86 @entity1 with Siewert type II @entity420 who underwent R0 resection at the Kitasato University between 1997 and 2013. Cox regression analysis using a backward stepwise selection method was performed to identify independent prognostic factors for relapse-free survival (RFS). RESULTS: The median age was 67 years. The male:female ratio was 74:12. Right thoracic, left thoracic and transhiatal approaches were performed in 10, 10 and 66 @entity1 , respectively, and perioperative transfusion in 16 @entity1 . Preoperative chemotherapy was administered to 19 @entity1 ; out of these, 13 received chemotherapy using the DCS regimen ( @entity1205 40 mg/m(2), day 1; @entity900 60 mg/m(2), day 1; S-1 80-120 mg/body, days 1-14; every 28 days). A median of three cycles of preoperative DCS chemotherapy were used. Histological responses of 1b, 2, 3 and unknown grades were obtained in three, three, four and three @entity1 , respectively. The 5-year RFS rate was 55%, and the median follow-up period was 36 months. Cox regression analysis regarding RFS identified (y)pN1-3 [hazard ratio (HR)=4.44; 95% confidence interval (CI)=1.98-11.27], performance of perioperative transfusion (HR=4.71; 95% CI=1.69-11.88) and no preoperative chemotherapy (HR=3.75; 95% CI=1.22-14.26) as significant and independent indicators of poor prognosis. CONCLUSION: Preoperative chemotherapy using DCS is potentially beneficial for Japanese @entity1 with Siewert type II @entity420 . Further prospective clinical studies are required to confirm our findings.
