Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database
Abstract
Background: In locally advanced esophagogastric adenocarcinoma (EGA), perioperative chemotherapy is the standard of care and can result in complete/major pathological response. In this setting, real-world data on the impact of postoperative chemotherapy are scarce. Objective: The primary objective was to assess the impact of postoperative chemotherapy on overall survival (OS) in cases of complete/major pathological response and/or no serosal involvement. Secondary endpoints were disease-free survival (DFS) and the identification of predictive factors associated with OS. Design: A retrospective comparative multicentric study was conducted using the nationwide, prospectively collected FREGAT (FRench EsoGAstric Tumor) database. Methods: Patients with EGA treated with perioperative chemotherapy registered in the FREGAT database who had a complete/major pathological response and/or no serosal involvement (ypT0–2 or ypT3 Mandard TRG 2, ypN0, R0) were included. Results: Among 1870 patients with EGA treated with perioperative chemotherapy identified in the FREGAT database, 345 met the inclusion criteria, and 218 (63.2%) received postoperative chemotherapy. Postoperative chemotherapy was associated with OS improvement regardless of the regimen used (median OS: not achieved vs 65.7 months; p < 0.0001). Similarly, DFS was improved with postoperative chemotherapy (median DFS: not achieved vs 65.7 months; p < 0.0001). In multivariable analysis, age, primary tumor location, postoperative complications, and no postoperative chemotherapy were associated with poorer survival outcomes. Conclusion: Postoperative chemotherapy after resection of EGA with complete/major pathological response and/or tumors without serosal involvement remains the standard of care, improves survival outcomes, and should be recommended when the patient’s condition allows it.
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BibTeX
@article{corazzin2026impact,
title = {{Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database}},
author = {Laure Corazzin and Elodie Jeanbert and Olivier Glehen and Caroline Gronnier and Laurent Sulpice and Jean-Marc Gornet and Brice Paquette and Jean-Marc Regimbeau and Cécile Brigand and Xavier-Benoît D’journo and Pierre-Yves Brichon and Johan Gagnaire and Thibault Voron and Muriel Mathonnet and Christophe Penna and Nicolas Regenet and Côme Lepage and Nicolas Carrere and Ugo Marchese and Leonor Benhaim and Jean-Michel Fabre and Frédéric Di Fiore and Frédéric Borie and Pierre Emmanuel Bonnot and Olivier Bouché and David Tougeron and Antoine Adenis and Guillaume Piessen and Marie Muller},
journal = {Therapeutic Advances in Medical Oncology},
year = {2026},
month = jul,
doi = {10.1177/17588359261435406},
url = {https://u-picardie.hal.science/hal-05712630v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database
AU - Laure Corazzin
AU - Elodie Jeanbert
AU - Olivier Glehen
AU - Caroline Gronnier
AU - Laurent Sulpice
AU - Jean-Marc Gornet
AU - Brice Paquette
AU - Jean-Marc Regimbeau
AU - Cécile Brigand
AU - Xavier-Benoît D’journo
AU - Pierre-Yves Brichon
AU - Johan Gagnaire
AU - Thibault Voron
AU - Muriel Mathonnet
AU - Christophe Penna
AU - Nicolas Regenet
AU - Côme Lepage
AU - Nicolas Carrere
AU - Ugo Marchese
AU - Leonor Benhaim
AU - Jean-Michel Fabre
AU - Frédéric Di Fiore
AU - Frédéric Borie
AU - Pierre Emmanuel Bonnot
AU - Olivier Bouché
AU - David Tougeron
AU - Antoine Adenis
AU - Guillaume Piessen
AU - Marie Muller
PY - 2026
DA - 2026/07/15
JO - Therapeutic Advances in Medical Oncology
DO - 10.1177/17588359261435406
UR - https://u-picardie.hal.science/hal-05712630v1
AB - Background: In locally advanced esophagogastric adenocarcinoma (EGA), perioperative chemotherapy is the standard of care and can result in complete/major pathological response. In this setting, real-world data on the impact of postoperative chemotherapy are scarce. Objective: The primary objective was to assess the impact of postoperative chemotherapy on overall survival (OS) in cases of complete/major pathological response and/or no serosal involvement. Secondary endpoints were disease-free survival (DFS) and the identification of predictive factors associated with OS. Design: A retrospective comparative multicentric study was conducted using the nationwide, prospectively collected FREGAT (FRench EsoGAstric Tumor) database. Methods: Patients with EGA treated with perioperative chemotherapy registered in the FREGAT database who had a complete/major pathological response and/or no serosal involvement (ypT0–2 or ypT3 Mandard TRG 2, ypN0, R0) were included. Results: Among 1870 patients with EGA treated with perioperative chemotherapy identified in the FREGAT database, 345 met the inclusion criteria, and 218 (63.2%) received postoperative chemotherapy. Postoperative chemotherapy was associated with OS improvement regardless of the regimen used (median OS: not achieved vs 65.7 months; p < 0.0001). Similarly, DFS was improved with postoperative chemotherapy (median DFS: not achieved vs 65.7 months; p < 0.0001). In multivariable analysis, age, primary tumor location, postoperative complications, and no postoperative chemotherapy were associated with poorer survival outcomes. Conclusion: Postoperative chemotherapy after resection of EGA with complete/major pathological response and/or tumors without serosal involvement remains the standard of care, improves survival outcomes, and should be recommended when the patient’s condition allows it.
SN - 1758-8340
SN - 1758-8359
ER -