Recurrence pattern of gastroesophageal junction adenocarcinoma after adjuvant and neo-adjuvant therapy in patients treated in radiotherapy center of Madani medical research and training hospital of Tabriz city

Abstract

Gastrointestinal adenocarcinoma (GEJ) is a global disease that affects 1.6 million cases per year. There have been many advances in the treatment of this disease in recent decades, and according to the results of many treatment studies, surgery alone is not acceptable, and neoadjuvant or adjuvant treatments are considered necessary along with surgical treatment. The majority of patients with GEJ adenocarcinoma are diagnosed when the primary tumor has invaded the subserous (T3) or involved regional lymph nodes, and in some cases, both subserosal invasion and lymph node involvement occur. have given. Standard diet chemotherapy is recommended for patients with systemic metastases. Despite numerous studies in this field, the effectiveness of neoadjuvant treatment compared to adjuvant is still debatable, and studies comparing the effectiveness of neoadjuvant and adjuvant treatment in the recurrence pattern of GEJ are very limited. Therefore, the aim of this study was to compare the two methods of neoadjuvant treatment and adjuvant treatment on the recurrence pattern in the treatment of GEJ adenocarcinoma. Materials and Methods: In this study, due to the descriptive nature of the study, all patients with GEJ adenocarcinoma who were eligible for inclusion in the study and were admitted to one of the two adjuvant or neoadjuvant methods in the radiotherapy ward of the Madani Training Center were included in the studied. The study samples were related to patients of the last 5 years. The data obtained from the study were analyzed using statistical software spss.16.

Results: In patients with neoadjuvant method, 3 (4.5%) cases had recurrence at the site of cardia, 2 (3%) cases had abdominal lymphadenopathy, 5 (7.6%) cases had liver metastases, 13 (19.7%) cases had metastases elsewhere, and 43 (65.2%) cases were without recurrence. In the group of patients with adjuvant method, 2 (5.9%) cases had recurrences at the site of anastomosis and surgery, 4 (11.8%) cases had abdominal lymphadenopathy, 1 (2.9%) cases had liver metastases, 9 (26.5%) cases had metastases elsewhere and 18 (52.9%) cases were without any recurrence, which this difference between the two groups was not statistically significant (p = 0.059).