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.

Keywords

esophagogastric junction adenocarcinoma FLOT gastric adenocarcinoma pathological response perioperative chemotherapy

Introduction

Gastric cancer, which is the main histological subtype, is adenocarcinoma,¹ and is a leading cause of mortality and a public health problem worldwide. It is the sixth most common cancer and the third leading cause of cancer-related death worldwide, with 1.1 million new cases and 770,000 deaths in 2021.^2–4 Europe accounted for an estimated 136,038 cases and 96,997 deaths in these global numbers.^1,2 Esophagogastric junction and gastric adenocarcinomas (EGA) have a poor prognosis. At diagnosis, 60% of patients with EGA are not eligible for curative treatment owing to late presentation or comorbidities.⁵ When resected, the recurrence rate of EGA remains high (20%–50%), and then overall survival (OS) rarely exceeds 12–15 months.^6–8

Over the past two decades, several therapeutic strategies have been assessed in prospective trials^9–13 to improve the rate of curative resection by down-staging the tumor, to reduce the risk of recurrence of resected EGA (eliminating micro metastases), rapidly improving tumor-related symptoms, and to determine the tumor’s sensitivity to chemotherapy. In 2006, the MAGIC trial⁹ was the first and largest randomized study that demonstrate a significant improvement in OS for patients with resectable EGA, when treated with surgery and perioperative chemotherapy (epirubicin, cisplatin, fluorouracil/ECF regimen; 3 cycles before and 3 cycles after surgery; q3w), compared to those treated with surgical resection alone (hazard ratio (HR) = 0.75, 5-year survival rate of 36% vs 23%; p = 0.009). The standard of care in resectable EGA is still perioperative treatment: until recently, the FLOT regimen (fluorouracil, oxaliplatin, docetaxel; 4 cycles before and 4 cycles after surgery; q2w) was the recommended strategy, following the results of the phase III FLOT4 trial,¹³ which demonstrated a significant improvement in OS (HR = 0.77, median OS: 50 vs 35 months) and in the complete pathological response rate (15% vs 6%; p = 0·02) compared to ECF/ECX (epirubicin, cisplatin, and fluorouracil/capecitabine) regimen. It has also recently been shown that the perioperative FLOT strategy is more effective than neoadjuvant chemoradiotherapy, which remains a therapeutic alternative.^14,15 Nowadays, the perioperative FLOT regimen associated with durvalumab (anti-PD-L1; 1500 mg, every 4 weeks in preoperative setting (2 cycles) followed by 10 cycles in the postoperative setting) is considered the new standard of care for localized EGA^3,16 following the publication of the recent phase III MATTERHORN trial results.^16,17 Compared to the perioperative FLOT regimen alone, FLOT plus durvalumab significantly improved event-free survival (67.4% vs 58.5%; HR = 0.71; p < 0.001), OS (HR = 0.78; p = 0.021), and the complete pathological response rate (19% vs 7%, odds ratio 3.08; p < 0.00001).^16–18

The significant improvement of pathological response in the surgical specimen since the introduction of the perioperative FLOT strategy raises the question of whether postoperative chemotherapy should be done in cases of a complete/major pathological response and/or tumor without serosal involvement. Some data suggest that continuing postoperative chemotherapy (same protocol as administered preoperatively) provides survival benefits,^1,19 notably in cases where there is no complete pathological response on the resected tumor, as presented in the retrospective SPACE-FLOT study.¹⁹ However, these data have not been stratified according to pathological response rate. Furthermore, data from the MAGIC trial showed that the presence of lymph node metastases on surgical specimen, rather than the pathological response to preoperative chemotherapy (Mandard tumor regression grade/TRG 3, 4, or 5 vs TRG 1 or 2),²⁰ was the only independent predictor of survival following chemotherapy and resection.⁹

To address those uncertainties, the aim of this study was to assess the clinical impact of postoperative chemotherapy on survival outcomes in patients with locally advanced EGA with a complete/major pathological response and/or tumor without serosal involvement after preoperative chemotherapy.

Patients and methods

Patients

A retrospective comparative multicentric study was conducted using the nationwide, prospectively collected FREGAT (FRench EsoGAstric Tumor) database. FREGAT is a national, multicenter, prospective cohort study of adult patients treated for esophageal or gastric cancer (NCT02526095).²¹ This study is reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.²²

For this study, all patients with locally advanced EGA at diagnosis treated with perioperative chemotherapy (regardless of the regimen used) registered in the FREGAT database and with documented complete/major pathological response and/or tumor without serosal involvement (i.e., ypT0-2, ypN0, R0 or ypT3 Mandard TRG 2, ypN0, R0) after preoperative chemotherapy (at least 6 weeks of preoperative chemotherapy) diagnosed between January 2015 and January 2024 were included. These pathological criteria were chosen because they are associated with a lower risk of recurrence, especially for ypT3 tumors, which are heterogeneous. A Mandard TRG 1–2 pathological response is also associated with better survival outcomes, notably for ypT3 tumors.^23–27 Patients registered in the database but without follow-up data were not included.

Data collection

Data were extracted from the FREGAT database. Patients’ and tumors’ characteristics, epidemiological, preoperative, and postoperative treatments, pathological data, follow-up, and survival data were collected, as well as the date of the last follow-up and the date/cause of death.

Objectives

The main objective was to assess the real-world impact of postoperative chemotherapy on OS of patients who were resected for locally advanced EGA and who had a complete/major pathological response and/or tumor without serosal involvement after preoperative chemotherapy.

The secondary endpoint was first to assess disease-free survival (DFS). Other secondary endpoints were exploratory and aimed to identify predictive factors associated with OS in the study population. OS and DFS were also compared according to time to resumption of chemotherapy (⩽8 vs >8 weeks after surgical resection)^28–30 in patients who received postoperative chemotherapy.

Statistical analyses

Continuous variables were described as medians with their 25–75 interquartile (Q1, Q3) and compared with Student or Wilcoxon tests. Categorical variables were described as frequencies and percentages and compared using the Chi-square test or Fisher’s exact test, as most appropriate.

OS was defined as the time elapsed between EGA surgical resection and death from any cause. Patients were censored at their last known follow-up before the database lock.

DFS was defined as the time elapsed between EGA surgical resection and disease recurrence (defined as radiological recurrence on tomodensitometry following RECIST 1.1 criteria) or death.

Median OS and DFS were estimated by the Kaplan–Meier method and compared by the log-rank test. Survival analyses were performed on the overall study population and by treatment type (before FLOT era vs after FLOT era).

As part of a prespecified sensitivity analysis, OS was assessed using a Cox proportional hazards model adjusted for the stratification factors: sex, age at EGA diagnosis, tumor location (esophagogastric junction/lower esophagus vs gastric), cT, chemotherapy regimen (triplet chemotherapy with taxane vs others), postoperative complications (according to Dindo-Clavien classification (grade 1 vs >1)), and postoperative chemotherapy. The factors associated with OS were identified with a Cox model. Variables with a p-value <0.2 in the univariable model were eligible for the multivariable model. A stepwise selection procedure was applied. The significance threshold was set at 5%. Analyses were performed using SAS 9.4 (SAS Inst., Cary, NC, USA).

Results

Description of the study population

In the FREGAT database, 1870 patients with EGA and perioperative chemotherapy were identified. After excluding patients who were treated with preoperative or postoperative concomitant chemoradiotherapy (n = 141), who presented with metastatic disease at diagnosis (n = 100), who showed no complete/major pathological response (n = 1191), and cases with missing follow-up data (n = 93), 345 patients met the inclusion criteria and were finally included in the study (Figure 1). Among them, 218 (63.2%) received adjuvant chemotherapy, and 127 (36.8%) did not. In the whole cohort, 277 (80.3%) were male, and the median age at EGA diagnosis was 66.0 years old (Q1–Q3: 57–72). Most of the tumors were located at the esophagogastric junction (45.3%), one-third (34.5%) were gastric, and 20.2% were located in the lower third of the esophagus. Half of the tumors were classified as cN+ at radiological baseline evaluation. Regarding the chemotherapy protocols administered, 195 patients (56.5%) were treated with perioperative triplet chemotherapy including a taxane according to the FLOT (docetaxel 50 mg/m² on day 1, oxaliplatin 85 mg/m² on day 1, leucovorin 200 mg/m² on day 1, and 5-FU 2600 mg/m² as 24-h infusion on day 1, q2w, 4 cycles pre- and postoperative) or DCF (docetaxel 75 mg/m², cisplatin 75 mg/m² (day 1) plus fluorouracil 750 mg/m² days 1–5, q3w, 3 cycles preoperative and postoperative) regimens.

Figure 1.

Flow chart of the study population.

Considering the two distinct groups of patients (no postoperative chemotherapy vs postoperative chemotherapy), some significant differences were noticed (Table 1). There was an overrepresentation of women in the subgroup receiving postoperative chemotherapy (22.9% vs 14.2%; p = 0.0485). In that same group, patients were also older at EGA diagnosis (35.8% aged ⩽60 years old vs 25.2%; p = 0.0046), had gastric tumors more often (39.9% vs 25.2%, p = 0.0056), and were more exposed to the FLOT regimen (63.3% vs 44.9%, p = 0.0068). In the no postoperative chemotherapy group, patients did not receive postoperative chemotherapy for two main reasons: postoperative complications (33%) and the oncologist’s or patient’s choice (16%). Indeed, during the postoperative period, patients in that group were more likely to present an altered general condition (ECOG PS >1, 45.4% vs 21.0%; p < 0.0001) and had more postoperative complications (p < 0.0001).

Table 1.

Patients’ and tumors’ characteristics at the esophagogastric junction or gastric adenocarcinoma diagnosis.

Patients’ and tumors’ characteristics	Postoperative chemotherapy arm (n = 218)	No postoperative chemotherapy arm (n = 127)	p Value
Sex			0.0485
Male, n (%)	168 (77.1)	109 (85.8)
Female, n (%)	50 (22.9)	18 (14.2)
Age (years) at EGA diagnosis, median (Q1, Q3)	68.0 (59.75–74)	66.0 (57–71)	0.0419
Tobacco consumption, n (%)	129 (59.2)	88 (69.3)	0.0606
Alcohol consumption, n (%)	59 (27.1)	40 (31.5)	0.3801
Primary tumor location			0.0056
Esophagus/esogastric junction, n (%)	131 (60.1)	95 (74.8)
Stomach, n (%)	87 (39.9)	32 (25.2)
Tumor clinical staging (N) at diagnosis			0.0848
cN0, n (%)	91 (42.7)	66 (52.4)
cN+, n (%)	122 (57.3)	60 (47.6)
Tumoral pathological subtype			0.0796
Adenocarcinoma, n (%)	209 (95.9)	123 (96.9)
Signet ring cells, n (%)	9 (4.1)	2 (1.6)
Chemotherapy regimens			0.009
Triplet with taxane (FLOT or DCF), n (%)	138 (63.3)	57 (44.9)
Platinum salt and fluoropyrimidine, n (%)	67 (30.7)	60 (47.2)
ECF/ECX, n (%)	10 (4.6)	7 (5.5)
Other, n (%)	3 (1.4)	3 (2.4)

DCF, docetaxel, cisplatin, and fluorouracil; ECF/ECX, epirubicin, cisplatin, and fluorouracil/capecitabine; EGA, esophagogastric junction and gastric adenocarcinoma; FLOT, 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel; Q1, first quartile; Q3, third quartile.

Patients, chemotherapy regimens, and tumors’ main characteristics are described in Table 1.

Survival data

In the whole cohort, the median follow-up was 45.1 months from the date of EGA surgery and death.

There was a significant difference in survival outcomes in patients resected for EGA in complete/major pathological response and/or tumor without serosal involvement (i.e., ypT0-2, ypN0, R0 or ypT3 Mandard TRG 2, ypN0, R0) after preoperative chemotherapy, according to the postoperative therapeutic strategy (no postoperative chemotherapy vs postoperative chemotherapy). In the no postoperative chemotherapy group, median OS was not achieved versus 65.7 months when treated with postoperative chemotherapy (p < 0.0001, Figure 2). After adjusting for factors that differed between groups, the difference in survival remained statistically significant (p = 0.0011). Adjuvant chemotherapy was independently associated with improved OS. Similarly, the median DFS rate was not achieved versus 65.7 months with postoperative chemotherapy (p < 0.0001, Figure 3). Those findings were confirmed by a sensitivity analysis that excluded patients with ypT3N0 Mandard 2 (median OS not achieved with postoperative chemotherapy vs 80.6 months; p < 0.0001, Supplemental Material 1(A) and median DFS not achieved with postoperative chemotherapy vs 65.7 months, Supplemental Material 1(B)). These findings were also observed when adjusting for factors that differed between groups and regardless of the chemotherapy regimen administered (triplet chemotherapy including a taxane (i.e., FLOT or DCF) vs other regimens, Supplemental Material 2(A) and (B)).

Figure 2.

Overall survival curves in patients with locally advanced esophagogastric junction and gastric adenocarcinoma treated with postoperative chemotherapy versus no postoperative chemotherapy.

Figure 3.

Disease-free survival curves in patients with locally advanced esophagogastric junction and gastric adenocarcinoma treated with postoperative chemotherapy versus no postoperative chemotherapy.

Prognosis data

In univariate analysis, age (>60 vs ⩽60 years old), primary tumor location, tobacco consumption, ypT stage, chemotherapy regimen, administration of postoperative chemotherapy, and postoperative complications were associated with OS. In multivariate analysis, age, primary tumor location, postoperative complications, and the administration of postoperative chemotherapy were the four identified prognosis factors associated with poorer survival outcomes (age >60 vs ⩽60 years old: HR = 1.9; p = 0.0235; esophageal/cardia primary tumors location: HR = 2.3; p = 0.0065; postoperative complications: HR = 1.9; p = 0.0076; no postoperative chemotherapy vs postoperative chemotherapy: HR = 2.1; p = 0.0020). Details are provided in Table 2.

Table 2.

Clinical, biological, and pathological factors associated with the overall survival rate.

Clinical/biological/pathological factors	All patients (n = 345)	Death (n, %)	HR (95% CI)	Univariate regression	HR (95% CI)	Multivariate analysis
Sex				0.1417
Male	277	68 (24.5)
Female	68	10 (14.7)
Age at EGA diagnosis				0.0069		0.0235
⩽60 years	110	15 (13.6)
>60 years old	235	63 (26.8)	2.2 (1.2–3.8)		1.9 (1.1–3.4)
Tobacco consumption				0.1964
No	128	25 (19.5)
Yes	217	53 (24.4)	1.4 (0.8–2.2)
Preoperative ASA score				0.3431
1	43	9 (20.9)
2	193	40 (20.7)	1.0 (0.5–2.1)
3	93	24 (25.8)	1.3 (0.6–2.8)
4	4	2 (50.0)	3.1 (0.7–14.4)
Primary tumor location				0.0010		0.0065
Stomach	119	15 (12.6)
Esophagus and junction	226	63 (27.9)	2.6 (1.5–4.7)		2.3 (1.3–4.0)
Postoperative tumoral stage (ypT)				0.0571
ypT0	106	15 (14.2)
ypTis	4	2 (50.0%)	3.7 (0.8–16.1)
ypT1a	52	10 (19.2)	1.4 (0.6–3.1)
ypT1b	78	19 (24.4)	1.9 (0.9–3.7)
ypT2	82	22 (26.8)	1.8 (0.9–3.5)
ypT3	23	10 (43.5)	3.4 (1.5–7.5)
Chemotherapy regimens				0.4269
Triplet with taxane (FLOT or DCF), n (%)	195	37 (19.0)
Others, n (%)	150	41 (27.3)	1.2 (0.8–1.9)
Postoperative chemotherapy				<0.0001		0.0020
Yes	218	33 (15.1)
No	127	45 (35.4)	2.7 (1.7–4.3)		2.1 (1.3–3.3)
Postoperative complications				<0.0001		0.0076
No, n (%)	222	36 (16.2)
Yes, n (%)	123	42 (34.1)	2.4 (1.6–3.8)		1.9 (1.2–3.0)

ASA, American Society of Anaesthesiologists; CI, confidence interval; DCF, docetaxel, cisplatin, and fluorouracil; EGA, esophagogastric junction and gastric adenocarcinoma; FLOT, 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel; HR, hazard ratio.

Among patients who received postoperative chemotherapy, those who started treatment more than 8 weeks after surgery had a worse median DFS (median DFS not reached; p = 0.00082, Supplemental Material 3(A)), and median OS (median OS not reached; p = 0.0294, Supplemental Material 3(B)).

Discussion

In locally advanced EGA, perioperative chemotherapy has become a commonly used treatment strategy in Western countries over the past two decades. However, there have been some changes over time regarding the preferred perioperative chemotherapy regimen.¹ Since 2019 and the publication of the results of the FLOT4 phase III trial, the FLOT triplet regimen is the standard of care in this setting, provided that the patient is in good general health (i.e., ECOG PS 0–1) and the tumor does not have a deficiency in the mismatch repair system (dMMR)/microsatellite instability (MSI). To our knowledge, we reported here one of the most important retrospective multicenter studies assessing the impact of postoperative chemotherapy on survival outcomes in patients with locally advanced EGA who presented a complete/major pathological response and/or a tumor without serosal involvement after preoperative chemotherapy. In that specific context, and especially since the perioperative “FLOT era,” the use of postoperative chemotherapy is perceived to be limited in the real-world setting. Based on the multicenter and prospective FREGAT cohort, we showed that postoperative chemotherapy was significantly associated with an improvement in OS and DFS for resected EGA that were in complete/major pathological response and/or without serosal involvement (i.e., ypT0-2, ypN0, R0 or ypT3 Mandard TRG 2, ypN0, R0) after preoperative chemotherapy. These results were observed regardless of the chemotherapy regimens administered, especially a triplet regimen using a taxane (FLOT or DCF), considering that three-drug regimens such as the parent DCF would be associated with comparable efficacy profiles in the perioperative setting.^13,31,32 A landmark analysis at 200 days confirmed that the survival benefit of postoperative chemotherapy was mainly early (0–200 days: HR = 15.7), whereas the late period showed attenuated and non-significant differences (>200 days: HR = 1.53). Such results emphasize the importance of maintaining chemotherapy after surgery, if the patient’s condition allows it, which is the current standard of care.¹

Recently, two retrospective studies^19,33 also assessed the value of postoperative chemotherapy in real-world settings. In the first one,³³ 147 patients resected for locally advanced EGA after preoperative FLOT were studied: tumors were mainly ypT3-4 (65.9%), ypN+ (56.4%), and R1/2 (20%). Authors demonstrated that survival rates of patients with marked tumor regression (TRG 1) were not improved by adjuvant chemotherapy. In the international cohort SPACE-FLOT study,¹⁹ DFS (HR = 0.73; 95% CI: 0.58–0.92) and OS (HR = 0.63; 95% CI: 0.50–0.79) were significantly higher with postoperative FLOT in cases of partial pathological response in the resected tumor. However, no significant differences in DFS or OS were observed in cases of minimal or complete pathological response. In our cohort, patients achieving a complete/major pathological response after preoperative chemotherapy also exhibited favorable survival outcomes despite omission of postoperative chemotherapy, suggesting that the main therapeutic benefit may be derived from the preoperative phase. The latter study showed that it was difficult to deliver the postoperative component of perioperative chemotherapy, with a substantial proportion of patients unable to complete postoperative treatment.

Although our results are significant, our study presents some limitations. The most significant of these is that the new standard of care for localized EGA is now the combination of the FLOT triplet with durvalumab since the recent phase III MATTERHORN results demonstrated a significant improvement in both recurrence-free¹⁶ and OS¹⁷ compared to the FLOT triplet alone (considered as the new standard of care; however, this regimen is not yet included in the routine clinical practice, pending from authorities approval in some countries). Therefore, our results need to be validated in the context of the MATTERHORN regimen. Moreover, other biases are due to the retrospective setting and the disparities observed in the two groups of patients. Cause-specific mortality could not be reliably assessed, and competing causes of death may have contributed to OS outcomes. A significantly higher rate of postoperative complications was observed in patients who did not receive postoperative chemotherapy. This constitutes a notable selection bias, especially since it is a factor associated with poorer survival.³⁴

In addition, some analyses could not be performed due to insufficient data and statistical power, which were affected by small sample sizes in certain patient subgroups (e.g., signet ring cells adenocarcinoma were rare in our study, mainly excluded due to a pathological response considered “poor” according to our inclusion criteria). Similarly, molecular biology data (e.g., dMMR/MSI status, HER2, or Claudin 18.2 immunohistochemistry results) could not be studied, as most of them were unavailable. Our observations should therefore be treated with caution. In addition, it was not possible to conduct radiological/pathological reviews. Consequently, potential inconsistencies in TRG assessment between centers are possible, which could have implications for the interpretation of results. Furthermore, it was not possible to make a centralized decision about the time to disease recurrence, which may also have introduced bias. Consequently, only the ATTENUATION phase III trial, which will begin enrollment in 2026, will be able to answer all these questions. This trial will prospectively assess the impact of postoperative chemotherapy with FLOT in cases of a complete/major pathological response (i.e., ypT0- 2, ypN0, R0 or ypT3 Mandard TRG 2, ypN0, R0) on surgical specimens following preoperative chemotherapy. Although the ATTENUATION study will use the perioperative FLOT regimen, it may provide additional information on the therapeutic strategy to adopt in cases involving a very good pathological response and/or a tumor without serosal involvement following preoperative chemotherapy. MATTERHORN applied a uniform treatment intensification strategy to all patients, regardless of their pathological response to preoperative chemotherapy. As a consequence, this approach does not address the marked heterogeneity in tumor biology and treatment sensitivity observed after neoadjuvant therapy. While MATTERHORN¹⁶ supports treatment escalation for patients at higher risk, it also highlights the unmet need for response-adapted strategies. The ATTENUATION study specifically addresses this gap by evaluating whether postoperative surveillance may be a safe and clinically meaningful alternative in patients with a good pathological response to preoperative chemotherapy, potentially avoiding overtreatment and unnecessary toxicity. A better understanding of the molecular biology of EGAs, along with the identification of new therapeutic targets, will help to personalize perioperative treatment for EGAs in the near future.

Conclusion

In this real-world study from the prospective FREGAT cohort, we observed that postoperative chemotherapy following resection of EGA in cases of major pathological response after preoperative chemotherapy resulted in significant improvements in OS and DFS. Therefore, in accordance with international guidelines and pending the results of the prospective French trial ATTENUATION, postoperative chemotherapy remains the standard of care for patients fit for adjuvant chemotherapy, whatever the response to the neoadjuvant chemotherapy.

Supplemental Material

sj-docx-1-tam-10.1177_17588359261435406 – Supplemental material for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database

Supplemental material, sj-docx-1-tam-10.1177_17588359261435406 for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database by Laure Corazzin, Elodie Jeanbert, Olivier Glehen, Caroline Gronnier, Laurent Sulpice, Jean-Marc Gornet, Brice Paquette, Jean-Marc Regimbeau, Cécile Brigand, Xavier-Benoît D’Journo, Pierre-Yves Brichon, Johan Gagnaire, Thibault Voron, Muriel Mathonnet, Christophe Penna, Nicolas Regenet, Côme Lepage, Nicolas Carrere, Ugo Marchese, Leonor Benhaim, Jean-Michel Fabre, Frédéric Di Fiore, Frédéric Borie, Pierre Emmanuel Bonnot, Olivier Bouché, David Tougeron, Antoine Adenis, Guillaume Piessen and Marie Muller in Therapeutic Advances in Medical Oncology

Supplemental Material

sj-docx-2-tam-10.1177_17588359261435406 – Supplemental material for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database

Supplemental material, sj-docx-2-tam-10.1177_17588359261435406 for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database by Laure Corazzin, Elodie Jeanbert, Olivier Glehen, Caroline Gronnier, Laurent Sulpice, Jean-Marc Gornet, Brice Paquette, Jean-Marc Regimbeau, Cécile Brigand, Xavier-Benoît D’Journo, Pierre-Yves Brichon, Johan Gagnaire, Thibault Voron, Muriel Mathonnet, Christophe Penna, Nicolas Regenet, Côme Lepage, Nicolas Carrere, Ugo Marchese, Leonor Benhaim, Jean-Michel Fabre, Frédéric Di Fiore, Frédéric Borie, Pierre Emmanuel Bonnot, Olivier Bouché, David Tougeron, Antoine Adenis, Guillaume Piessen and Marie Muller in Therapeutic Advances in Medical Oncology

Supplemental Material

sj-docx-3-tam-10.1177_17588359261435406 – Supplemental material for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database

Supplemental material, sj-docx-3-tam-10.1177_17588359261435406 for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database by Laure Corazzin, Elodie Jeanbert, Olivier Glehen, Caroline Gronnier, Laurent Sulpice, Jean-Marc Gornet, Brice Paquette, Jean-Marc Regimbeau, Cécile Brigand, Xavier-Benoît D’Journo, Pierre-Yves Brichon, Johan Gagnaire, Thibault Voron, Muriel Mathonnet, Christophe Penna, Nicolas Regenet, Côme Lepage, Nicolas Carrere, Ugo Marchese, Leonor Benhaim, Jean-Michel Fabre, Frédéric Di Fiore, Frédéric Borie, Pierre Emmanuel Bonnot, Olivier Bouché, David Tougeron, Antoine Adenis, Guillaume Piessen and Marie Muller in Therapeutic Advances in Medical Oncology

Supplemental Material

sj-docx-4-tam-10.1177_17588359261435406 – Supplemental material for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database

Supplemental material, sj-docx-4-tam-10.1177_17588359261435406 for Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database by Laure Corazzin, Elodie Jeanbert, Olivier Glehen, Caroline Gronnier, Laurent Sulpice, Jean-Marc Gornet, Brice Paquette, Jean-Marc Regimbeau, Cécile Brigand, Xavier-Benoît D’Journo, Pierre-Yves Brichon, Johan Gagnaire, Thibault Voron, Muriel Mathonnet, Christophe Penna, Nicolas Regenet, Côme Lepage, Nicolas Carrere, Ugo Marchese, Leonor Benhaim, Jean-Michel Fabre, Frédéric Di Fiore, Frédéric Borie, Pierre Emmanuel Bonnot, Olivier Bouché, David Tougeron, Antoine Adenis, Guillaume Piessen and Marie Muller in Therapeutic Advances in Medical Oncology

Footnotes

Acknowledgements

None.

Declarations

ORCID iD

Marie Muller

Supplemental material

Supplemental material for this article is available online.

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