title: Impact of pathologic complete response on disease-free survival in patients with esophagogastric adenocarcinoma receiving preoperative docetaxel-based chemotherapy.
abstract: BACKGROUND
  The aim of this study was to evaluate the impact of pathologic complete response (pCR) on outcome in patients with gastric or esophagogastric junction (EGJ) adenocarcinoma after neoadjuvant docetaxel/platin/fluoropyrimidine-based chemotherapy.
  
  
  METHODS
  Patients received at least one cycle of chemotherapy for potentially operable disease. Pretreatment clinicopathologic factors and pCR were investigated. Disease-free survival (DFS), overall survival (OS) and tumor-related death were correlated with pCR.
  
  
  RESULTS
  One hundred twenty patients were included in this analysis. Eighteen patients (15%) achieved a pCR. Tumor localization in the EGJ was identified as the only significant predictor of pCR (P = 0.019). Median follow-up was 41.1 months. Median DFS and OS for all patients were 24.1 and 48.6 months, respectively. Median DFS for patients with a pCR was not reached versus 22.1 months non-pCR patients (hazard ratio, HR 0.38; 3-year DFS: 71.8% and 37.7%, respectively, P = 0.018). While OS was not significantly different, the risk for tumor-related death was significantly lower for pCR patients compared with non-pCR patients (3-year cumulative incidences of 6.4% and 45.4%, respectively, P = 0.009).
  
  
  CONCLUSIONS
  A pCR following preoperative docetaxel/platin/fluoropyrimidine indicates favorable outcome in patients with gastric or EGJ adenocarcinoma. Tumor location in the EGJ is associated with a higher pCR rate.
authors.affiliation: 3rd Department of Internal Medicine, Hematology/Medical Oncology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. sylvie.lorenzen@mri.tum.de
authors.forename: S
authors.initials: S
authors.lastname: Lorenzen
authors.forename: P
authors.initials: P
authors.lastname: Thuss-Patience
authors.forename: S E
authors.initials: SE
authors.lastname: Al-Batran
authors.forename: F
authors.initials: F
authors.lastname: Lordick
authors.forename: B
authors.initials: B
authors.lastname: Haller
authors.forename: T
authors.initials: T
authors.lastname: Schuster
authors.forename: C
authors.initials: C
authors.lastname: Pauligk
authors.forename: K
authors.initials: K
authors.lastname: Luley
authors.forename: D
authors.initials: D
authors.lastname: Bichev
authors.forename: G
authors.initials: G
authors.lastname: Schumacher
authors.forename: N
authors.initials: N
authors.lastname: Homann
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D000077143:Docetaxel; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D004943:Esophagogastric Junction / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000188:drug therapy; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D013534:Survival; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use*; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D000964:Antimetabolites, Antineoplastic; D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D003841:Deoxycytidine; D014803:Vitamin B Complex; D000077143:Docetaxel; D000069287:Capecitabine; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil
keywords: docetaxel; esophagogastric adenocarcinoma; pathologic complete response; preoperative