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<p>Gastroesophageal junction (GEJ) cancers have shown a rising global incidence, with unique anatomical and biological features distinguishing them from esophageal and gastric carcinomas. This study evaluates the clinicopathological characteristics, treatment modalities, survival outcomes, and recurrence patterns of GEJ cancers in an Indian population. This study was conducted on 107 patients with histologically confirmed GEJ carcinoma treated at a tertiary cancer center in India between 2012 and 2024. Demographic, clinical, radiological, surgical, and survival data were reviewed. Staging was based on endoscopy and contrast-enhanced CT. Multimodality treatment strategies were implemented, including neoadjuvant chemoradiotherapy (CROSS), chemotherapy (FLOT), and definitive chemoradiotherapy for unresectable cases. Survival was analyzed using Kaplan–Meier methods, and predictors of recurrence were assessed using Cox regression. The cohort had a male-to-female ratio of 3.45:1 with a mean age of 53 years. Adenocarcinoma was the predominant histology (63.6%). Curative resection was achieved in 79.4%, with an R1 rate of 2.4%. The most common surgical approach was Ivor Lewis esophagectomy (63.6%). The 2-, 3-, and 5-year disease-free survival (DFS) rates were 82%, 75%, and 56%, respectively; overall survival (OS) rates were 88%, 77%, and 59%. Recurrence occurred in 35.3% of patients, predominantly systemic. On multivariate analysis, lympho-vascular invasion, extent of lymphadenectomy, and pathological stage significantly predicted recurrence. Gastroesophageal junction cancers in India predominantly affect middle-aged males and are mostly adenocarcinomas. Multimodality treatment, including neoadjuvant therapy and extended lymphadenectomy, shows promising survival. However, systemic recurrence remains a major challenge. Early detection, personalized treatment, and standardized follow-up are essential to improve outcomes. These findings highlight the urgent need for resource-sensitive national strategies to tackle the rising burden of GEJ cancers.</p>

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Clinicopathological Profile, Treatment Outcomes, and Survival Analysis in Carcinoma Gastro-Esophageal Junction: a 13-Year Comprehensive Evaluation of Patients Undergoing Curative and Non-curative Management

  • 期刊论文

  • 发表日期：

    2025年9月23日

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  • Amitabha Mandal,
  • Ritu Thakur,
  • Rohan Kapoor,
  • Sandeep Bhoriwal,
  • Naveen Kumar,
  • S. V. S. Deo,
  • Raghuram K,
  • Jyoti Sharma,
  • Jyoutishman Saikia,
  • Shivani Kapila,
  • Chethan R,
  • Sushmita Pathy,
  • Sunil Kumar

摘要

Gastroesophageal junction (GEJ) cancers have shown a rising global incidence, with unique anatomical and biological features distinguishing them from esophageal and gastric carcinomas. This study evaluates the clinicopathological characteristics, treatment modalities, survival outcomes, and recurrence patterns of GEJ cancers in an Indian population. This study was conducted on 107 patients with histologically confirmed GEJ carcinoma treated at a tertiary cancer center in India between 2012 and 2024. Demographic, clinical, radiological, surgical, and survival data were reviewed. Staging was based on endoscopy and contrast-enhanced CT. Multimodality treatment strategies were implemented, including neoadjuvant chemoradiotherapy (CROSS), chemotherapy (FLOT), and definitive chemoradiotherapy for unresectable cases. Survival was analyzed using Kaplan–Meier methods, and predictors of recurrence were assessed using Cox regression. The cohort had a male-to-female ratio of 3.45:1 with a mean age of 53 years. Adenocarcinoma was the predominant histology (63.6%). Curative resection was achieved in 79.4%, with an R1 rate of 2.4%. The most common surgical approach was Ivor Lewis esophagectomy (63.6%). The 2-, 3-, and 5-year disease-free survival (DFS) rates were 82%, 75%, and 56%, respectively; overall survival (OS) rates were 88%, 77%, and 59%. Recurrence occurred in 35.3% of patients, predominantly systemic. On multivariate analysis, lympho-vascular invasion, extent of lymphadenectomy, and pathological stage significantly predicted recurrence. Gastroesophageal junction cancers in India predominantly affect middle-aged males and are mostly adenocarcinomas. Multimodality treatment, including neoadjuvant therapy and extended lymphadenectomy, shows promising survival. However, systemic recurrence remains a major challenge. Early detection, personalized treatment, and standardized follow-up are essential to improve outcomes. These findings highlight the urgent need for resource-sensitive national strategies to tackle the rising burden of GEJ cancers.