Adenocarcinoma of the gastroesophageal junction (AEG) is an aggressive cancer with rising incidence and poor long-term survival despite multimodal treatment. Reliable preoperative prognostic markers are lacking. Methods: The study is based on data from a prospectively maintained institutional database, which was retrospectively analyzed. In total, 211 patients were analyzed who underwent curative resection for AEG to evaluate the association of SII and LVI and their combined prognostic value. Results: LVI was present in 45% of patients and was significantly associated with higher median SII values compared to patients without LVI (943 vs. 652; p < 0.001). Both high SII and the presence of LVI were independently associated with worse overall survival (p < 0.001 for both). In patients treated with primary surgery (65%), the combined presence of high SII and LVI identified a subgroup with particularly poor prognosis (pseudo-R2 increased from 0.451 to 0.524; likelihood-ratio test p < 0.001). Among patients who received neoadjuvant therapy (NT) (35%), SII remained a strong prognostic factor (pseudo-R2 = 0.432), while LVI alone was not statistically significant (p = 0.135), and its addition to the SII model did not improve prognostic performance (p = 0.377). Conclusions: The combined assessment of SII and LVI may improve prognostic stratification in AEG, especially in patients undergoing upfront surgery. These findings suggest that combined assessment of SII and LVI enhances prognostic stratification, particularly in patients treated with upfront surgery, and may aid personalized treatment and follow-up planning in AEG. To the best of our knowledge, this is the first study investigating the association of SII and LVI in AEG.
Jomrich et al. (Fri,) studied this question.
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