Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group).

Autor: Erol C; Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey., Sakin A; Department of Medical Oncology, Faculty of Medicine, Van Yüzüncü Yıl University, Van, Turkey., Başoğlu T; Department of Medical Oncology, School of Medicine, Marmara University, İstanbul, Turkey., Özden E; Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey., Çabuk D; Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey., Doğan M; Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey., Öksüzoğlu B; Department of Medical Oncology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey., Yıldırım HÇ; Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey., Öner İ; Department of Medical Oncology, Konya Meram State Hospital, Konya, Turkey., Eryılmaz MK; Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey., Dülgar Ö; Department of Medical Oncology, Göztepe Training and Research Hospital, İstanbul Medeniyet University, İstanbul, Turkey., Aydın D; Department of Medical Oncology, Derince Training and Research Hospital, Kocaeli, Turkey., Doğan N; Department of Medical Oncology, Prof. Dr. A. İlhan Özdemir Education and Research Hospital, Giresun University, Giresun, Turkey., Özen M; Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey., Hacıbekiroğlu İ; Department of Medical Oncology, Faculty of Medicine, Sakarya University, Sakarya, Turkey., Özdemir N; Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey., Gürler F; Department of Medical Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey., Paksoy N; Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey., Karabulut S; Department of Medical Oncology, Institute of Oncology, İstanbul University, İstanbul, Turkey., Aksoy A; Department of Medical Oncology, Faculty of Medicine, Fırat University, Elazığ, Turkey., Hızal M; Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey., Kahraman S; Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey., Şen E; Department of Medical Oncology, Çanakkale Mehmet Akif Ersoy State Hospital, Çanakkale, Turkey., Paydaş S; Department of Medical Oncology, Faculty of Medicine, Çukurova University, Adana, Turkey., Çılbır E; Department of Medical Oncology, Dışkapı Training and Research Hospital, Ankara, Turkey., Fırat F; Department of Medical Oncology, Faculty of Medicine, İnönü University, Malatya, Turkey., Akdeniz N; Department of Medical Oncology, Adıyaman Training and Research Hospital, Adıyaman, Turkey., Özçelik M; Department of Medical Oncology, Ümraniye Education and Research Hospital, İstanbul, Turkey., Oyman A; Department of Medical Oncology, Ümraniye Education and Research Hospital, İstanbul, Turkey., Baytemür NK; Department of Medical Oncology, Memorial Ankara Hospital, Ankara, Turkey., Acar R; Department of Medical Oncology, Gülhane Education and Research Hospital, Ankara, Turkey., Almuradova E; Department of Medical Oncology, Faculty of Medicine, Ege University, İzmir, Turkey., Karabulut B; Department of Medical Oncology, Faculty of Medicine, Ege University, İzmir, Turkey., Şakalar T; Department of Medical Oncology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey., Arak H; Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey., Değerli E; Department of Medical Oncology, Cerrahpaşa School of Medicine, İstanbul University, İstanbul, Turkey., Türker S; Department of Medical Oncology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey., Alan Ö; Department of Medical Oncology, Tekirdağ State Hospital, Tekirdağ, Turkey., Er Ö; Department of Medical Oncology, Acıbadem Maslak Hospital, İstanbul, Turkey., Taşçı EŞ; Department of Medical Oncology, Acıbadem Maslak Hospital, İstanbul, Turkey., Demir N; Department of Medical Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey., Çavdar E; Department of Medical Oncology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey., Turhal S; Department of Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey., Dede DŞ; Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke., Akıncı MB; Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke., Yalçın B; Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke., Yumuk F; Department of Medical Oncology, School of Medicine, Marmara University, İstanbul, Turkey., Yalçın Ş; Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey., Şendur MAN; Department of Medical Oncology, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turke.
Jazyk: angličtina
Zdroj: Turkish journal of medical sciences [Turk J Med Sci] 2022 Aug; Vol. 52 (4), pp. 1022-1032. Date of Electronic Publication: 2022 Aug 10.
DOI: 10.55730/1300-0144.5404
Abstrakt: Background: Perioperative FLOT regimen is a standard of care in locally advanced operable gastric and GEJ adenocarcinoma. We aimed to determine the efficacy, prognostic factors of perioperative FLOT chemotherapy in real-life gastric and GEJ tumors.
Methods: The data of patients who were treated with perioperative FLOT chemotherapy were retrospectively analyzed from 34 different oncology centers in Turkey. Baseline clinical and demographic characteristics, pretreatment laboratory values, histological and molecular characteristics were recorded.
Results: A total of 441 patients were included in the study. The median of age our study population was 60 years. The majority of patients with radiological staging were cT3-4N(+) (89.9%, n = 338). After median 13.5 months (IQR: 8.5-20.5) follow-up, the median overall survival was NR (95% CI, NR to NR), and median disease free survival was 22.9 (95% CI, 18.6 to 27.3) months. The estimated overall survival at 24 months was 62%. Complete pathological response (pCR) and near pCR was achieved in 23.8% of all patients. Patients with lower NLR or PLR have significantly longer median OS (p = 0.007 and p = 0.033, respectively), and patients with lower NLR have significantly longer median DFS (p = 0.039), but PLR level did not affect DFS (p = 0.062). The OS and DFS of patients with better ECOG performance scores and those who could receive FLOT as adjuvant chemotherapy instead of other regimens were found to be better. NLR was found to be independent prognostic factor for OS in the multivariant analysis. At least one adverse event reported in 57.6% of the patients and grade 3-4 toxicity was seen in 23.6% patients.
Discussion: Real-life perioperative FLOT regimen in operable gastric and GEJ tumors showed similar oncologic outcomes compared to clinical trials. Better performance status, receiving adjuvant chemotherapy as same regimen, low grade and low NLR and PLR improved outcomes in real-life. However, in multivariate analysis, only NLR affected OS.
Databáze: MEDLINE
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