Association between tumor response and postoperative morbidity after neoadjuvant chemotherapy for gastroesophageal adenocarcinoma?

Abstract

Aim: The recommended treatment for locally advanced gastroesophageal adenocarcinoma has changed to a multimodal approach including neoadjuvant chemotherapy. The aim of this study was to assess potential associations between response to neoadjuvant therapy and post-operative morbidity in patients with gastroesophageal adenocarcinoma.Methods: Sixty-one patients undergoing surgical resection of gastroesophageal adenocarcinoma following neoadjuvant chemotherapy were analyzed. Patients were dichotomized into histopathological responders (Becker grade Ia-II, n = 37) and nonresponders (Becker grade III, n = 24). Perioperative complications were assessed according to the Clavien-Dindo classification. An association between response to neoadjuvant chemotherapy and surgical complications was evaluated with the chi-square or Fisher test where appropriate.Results: Twenty over thirty-seven responders (54.1%) and 17/24 non-responders (70.8%) had perioperative complications of any grade (P = 0.19). The most frequent complications were anastomotic leakage, which had a higher incidence among non-responders (4/24; 16.7%) than responders (1/37; 2.7%; Fisher's test: P = 0.07); and pulmonary complications, which showed no difference in incidence between non-responders (11/24; 45.8%) and responders (13/37; 35.1%; P = 0.57).Conclusion: In patients undergoing resection of gastroesophageal adenocarcinoma after neoadjuvant chemotherapy, there was no association between response and incidence of perioperative complications. However, there was a borderline significant higher incidence of anastomotic leakage among non-responders