Adjuvant treatment efficacy in esophageal adenocarcinoma patients receiving neoadjuvant therapy and esophagectomy

• Published in: Neoplasma Vol. 72; no. 3; p. 200
• Main Authors: Xu, MaoTian, Xu, Fei, Luo, Jing, Zhang, Chi, Shen, Yi
• Format: Journal Article
• Language: English
• Published: Slovakia 01.06.2025
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - pathology; Adenocarcinoma - therapy; Adult; Aged; Chemotherapy, Adjuvant; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - therapy; Esophagectomy - methods; Female; Humans; Male; Middle Aged; Neoadjuvant Therapy - methods; SEER Program; Survival Rate; Treatment Outcome
• ISSN: 0028-2685
• DOI: 10.4149/neo_2025_250307N111

The application of adjuvant therapy following neoadjuvant treatment and subsequent esophagectomy remains a subject of debate due to the limited availability of comprehensive studies. This study aims to evaluate the role of adjuvant therapy in patients with esophageal adenocarcinoma (EAC) who have undergone neoadjuvant therapy and esophagectomy, thereby offering evidence-based guidance for clinical decision-making. Patients diagnosed with EAC and treated with neoadjuvant therapy followed by surgical intervention were enrolled in our study. The data for patients in the training cohort were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. To validate the findings, new patient cohorts were utilized. A total of 3,445 patients with EAC were identified from the SEER database based on the established eligibility criteria. The analysis revealed no significant differences between the adjuvant therapy group and the non-adjuvant therapy group in terms of 5-year overall survival, with rates of 35.7% and 37.2%, respectively (p=0.920), nor in 5-year cancer-specific survival, with rates of 39.5% and 43.2%, respectively (p=0.520). Additionally, 130 patients were identified from the Affiliated Jinling Hospital of Nanjing University's Medical School. In this cohort, findings indicated that patients receiving adjuvant therapy demonstrated improved overall survival compared to those not receiving such therapy (p=0.031). Leveraging the SEER database, our study demonstrated that adjuvant therapy did not confer a survival advantage for patients with EAC following neoadjuvant therapy and surgery. In contrast, data analysis from the Affiliated Jinling Hospital, Medical School of Nanjing University in China, indicated that EAC patients might indeed benefit from adjuvant therapy after undergoing neoadjuvant treatment and esophagectomy.