Progress on integrated treatment of adenocarcinoma of esophagogastric junction_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Jiadi , HUANG Yan , FANG Caiyan ,  YANG Hong

Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Esophageal Cancer Institute, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, P. R. China;

Corresponding author：

YANG Hong, Email: yanghong@sysucc.org.cn

Keywords：

Adenocarcinoma of esophagogastric junction; integrated treatment; evidence-based medicine; review

DOI：

10.7507/1007-4848.202008069

Video：

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Surgery is an accepted standard in the treatment of adenocarcinoma of esophagogastric junction (AEG), but the efficacy of surgery alone for locally advanced AEG is limited. In-depth studies concerning combined therapy for AEG have been carried out worldwide, including neoadjuvant chemotherapy (nCT), neoadjuvant chemoradiotherapy (nCRT), perioperative chemotherapy (pCT), postoperative chemoradiotherapy, etc. Significantly, the contribution of nCRT and pCT to improving the prognosis of locally advanced AEG patients has been shed light on. Compared with that, multimodality treatment for AEG patients is not well established in China. An attempt was thus made to take an overview of the evidence-based research advance regarding integrated therapy of AEG.

Citation： WU Jiadi, HUANG Yan, FANG Caiyan, YANG Hong. Progress on integrated treatment of adenocarcinoma of esophagogastric junction. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(2): 251-256. doi: 10.7507/1007-4848.202008069 Copy

1.	Rüdiger Siewert J, Feith M, Werner M, et al. Adenocarcinoma of the esophagogastric junction: Results of surgical therapy based on anatomical/topographic classification in 1, 002 consecutive patients. Ann Surg, 2000, 232(3): 353-361.
2.	National Comprehensive Cancer Network. Esophageal and esophagogastric junction cancers (Version 1.2020). Accessed on 18th March, 2020. https://www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf.
3.	Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: An updated meta-analysis. Lancet Oncol, 2011, 12(7): 681-692.
4.	Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol, 2009, 27(30): 5062-5067.
5.	Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med, 2006, 355(1): 11-20.
6.	Ychou M, Boige V, Pignon JP, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: An FNCLCC and FFCD multicenter phase Ⅲ trial. J Clin Oncol, 2011, 29(13): 1715-1721.
7.	Al-Batran SE, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): A randomised, phase 2/3 trial. Lancet, 2019, 393(10184): 1948-1957.
8.	van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med, 2012, 366(22): 2074-2084.
9.	Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): Long-term results of a randomised controlled trial. Lancet Oncol, 2015, 16(9): 1090-1098.
10.	Samson P, Robinson C, Bradley J, et al. Neoadjuvant chemotherapy versus chemoradiation prior to esophagectomy: Impact on rate of complete pathologic response and survival in esophageal cancer patients. J Thorac Oncol, 2016, 11(12): 2227-2237.
11.	Goense L, van der Sluis PC, van Rossum PSN, et al. Perioperative chemotherapy versus neoadjuvant chemoradiotherapy for esophageal or GEJ adenocarcinoma: A propensity score-matched analysis comparing toxicity, pathologic outcome, and survival. J Surg Oncol, 2017, 115(7): 812-820.
12.	Burmeister BH, Thomas JM, Burmeister EA, et al. Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase Ⅱ trial. Eur J Cancer, 2011, 47(3): 354-360.
13.	Klevebro F, Johnsen G, Johnson E, et al. Morbidity and mortality after surgery for cancer of the oesophagus and gastro-oesophageal junction: A randomized clinical trial of neoadjuvant chemotherapy vs. neoadjuvant chemoradiation. Eur J Surg Oncol, 2015, 41(7): 920-926.
14.	Stahl M, Walz MK, Stuschke M, et al. Phase Ⅲ comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol, 2009, 27(6): 851-856.
15.	van Hagen P, Wijnhoven BP, Nafteux P, et al. Recurrence pattern in patients with a pathologically complete response after neoadjuvant chemoradiotherapy and surgery for oesophageal cancer. Br J Surg, 2013, 100(2): 267-273.
16.	Yoo CH, Noh SH, Shin DW, et al. Recurrence following curative resection for gastric carcinoma. Br J Surg, 2000, 87(2): 236-242.
17.	Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med, 2001, 345(10): 725-730.
18.	Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): A phase 3, open-label, randomised controlled trial. Lancet, 2010, 376(9742): 687-697.
19.	Fuchs CS, Tomasek J, Yong CJ, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): An international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet, 2014, 383(9911): 31-39.
20.	Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): A double-blind, randomised phase 3 trial. Lancet Oncol, 2014, 15(11): 1224-1235.
21.	Kojima T, Muro K, Francois E, et al. Pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer: Phase Ⅲ KEYNOTE-181 study. J Clin Oncol, 2019, 37(4_suppl): 2.
22.	Ende TVD, Clercq NCD, Henegouwen MIVB, et al. A phase Ⅱ feasibility trial of neoadjuvant chemoradiotherapy combined with atezolizumab for resectable esophageal adenocarcinoma: The PERFECT trial. J Clin Oncol, 2019, 37(15_suppl): 4045.

1. Rüdiger Siewert J, Feith M, Werner M, et al. Adenocarcinoma of the esophagogastric junction: Results of surgical therapy based on anatomical/topographic classification in 1, 002 consecutive patients. Ann Surg, 2000, 232(3): 353-361.
2. National Comprehensive Cancer Network. Esophageal and esophagogastric junction cancers (Version 1.2020). Accessed on 18th March, 2020. https://www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf.
3. Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: An updated meta-analysis. Lancet Oncol, 2011, 12(7): 681-692.
4. Allum WH, Stenning SP, Bancewicz J, et al. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol, 2009, 27(30): 5062-5067.
5. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med, 2006, 355(1): 11-20.
6. Ychou M, Boige V, Pignon JP, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: An FNCLCC and FFCD multicenter phase Ⅲ trial. J Clin Oncol, 2011, 29(13): 1715-1721.
7. Al-Batran SE, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): A randomised, phase 2/3 trial. Lancet, 2019, 393(10184): 1948-1957.
8. van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med, 2012, 366(22): 2074-2084.
9. Shapiro J, van Lanschot JJB, Hulshof MCCM, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): Long-term results of a randomised controlled trial. Lancet Oncol, 2015, 16(9): 1090-1098.
10. Samson P, Robinson C, Bradley J, et al. Neoadjuvant chemotherapy versus chemoradiation prior to esophagectomy: Impact on rate of complete pathologic response and survival in esophageal cancer patients. J Thorac Oncol, 2016, 11(12): 2227-2237.
11. Goense L, van der Sluis PC, van Rossum PSN, et al. Perioperative chemotherapy versus neoadjuvant chemoradiotherapy for esophageal or GEJ adenocarcinoma: A propensity score-matched analysis comparing toxicity, pathologic outcome, and survival. J Surg Oncol, 2017, 115(7): 812-820.
12. Burmeister BH, Thomas JM, Burmeister EA, et al. Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase Ⅱ trial. Eur J Cancer, 2011, 47(3): 354-360.
13. Klevebro F, Johnsen G, Johnson E, et al. Morbidity and mortality after surgery for cancer of the oesophagus and gastro-oesophageal junction: A randomized clinical trial of neoadjuvant chemotherapy vs. neoadjuvant chemoradiation. Eur J Surg Oncol, 2015, 41(7): 920-926.
14. Stahl M, Walz MK, Stuschke M, et al. Phase Ⅲ comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol, 2009, 27(6): 851-856.
15. van Hagen P, Wijnhoven BP, Nafteux P, et al. Recurrence pattern in patients with a pathologically complete response after neoadjuvant chemoradiotherapy and surgery for oesophageal cancer. Br J Surg, 2013, 100(2): 267-273.
16. Yoo CH, Noh SH, Shin DW, et al. Recurrence following curative resection for gastric carcinoma. Br J Surg, 2000, 87(2): 236-242.
17. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med, 2001, 345(10): 725-730.
18. Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): A phase 3, open-label, randomised controlled trial. Lancet, 2010, 376(9742): 687-697.
19. Fuchs CS, Tomasek J, Yong CJ, et al. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): An international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet, 2014, 383(9911): 31-39.
20. Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): A double-blind, randomised phase 3 trial. Lancet Oncol, 2014, 15(11): 1224-1235.
21. Kojima T, Muro K, Francois E, et al. Pembrolizumab versus chemotherapy as second-line therapy for advanced esophageal cancer: Phase Ⅲ KEYNOTE-181 study. J Clin Oncol, 2019, 37(4_suppl): 2.
22. Ende TVD, Clercq NCD, Henegouwen MIVB, et al. A phase Ⅱ feasibility trial of neoadjuvant chemoradiotherapy combined with atezolizumab for resectable esophageal adenocarcinoma: The PERFECT trial. J Clin Oncol, 2019, 37(15_suppl): 4045.

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