25. THE ROLE OF ADJUVANT THERAPY FOR PATIENTS WITH ESOPHAGEAL ADENOCARCINOMA UNDERGOING NEOADJUVANT THERAPY AND ESOPHAGECTOMY

Abstract Background The use of adjuvant therapy after neoadjuvant therapy followed by esophagectomy is controversial due to limited studies. The aim of this study was to investigate the role of adjuvant therapy for patients with esophageal adenocarcinoma (EAC) after neoadjuvant therapy and esophagectomy and to provide a basis for clinical decision-making. Methods Patients who were diagnosed as EAC and underwent neoadjuvant therapy followed by surgery were included in this study. The data of the patients in training group are derived from Surveillance, Epidemiology, and End Results (SEER) database. Patients from two institutions (West China Hospital and Nanjing Jinling Hospital) were used to validate the results. Results A total of 3445 EAC patients were identified from the SEER database according to the eligibility criteria. No significant difference was found between adjuvnat therapy and non-adjuvant therapy group (5-year overall survival (OS): 35.7 and 37.2%, p = 0.920; 5-year cancer-specific survival (CSS): 39.5 and 43.2%, p = 0.520). Meanwhile, 130 patients were identified from West China Hospital (n = 84) and Jinling Hospital (n = 46). The results showed that patients undergoing adjuvant therapy group had a better OS than non-adjuvant therapy group (p = 0.031). Conclusion On the basis of the SEER database, this study revealed no survival benefit of adjuvant therapy for patients with EAC after neoadjuvant therapy and surgery. However, the analysis results of patients from two institutions in China show that patients with EAC may benefit from adjuvant therapy after neoadjuvant therapy and esophagectomy.