Perioperative FLOT Chemotherapy Plus Surgery for Oligometastatic Esophagogastric Adenocarcinoma: Surgical Outcome and Overall Survival
| Autor: | Mira Runkel, Rasmus Verst, Julia Spiegelberg, Stefan Fichtner-Feigl, Jens Hoeppner, Torben Glatz |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Perioperative chemotherapy Esophageal Neoplasms Organoplatinum Compounds Esophageal cancer lcsh:Surgery Leucovorin lcsh:RD1-811 Adenocarcinoma Neoadjuvant Therapy Oxaliplatin Survival Rate Treatment Outcome Stomach Neoplasms Antineoplastic Combined Chemotherapy Protocols Humans Female Taxoids Esophagogastric Junction Fluorouracil Gastric cancer Oligometastases Retrospective Studies Research Article |
| Zdroj: | BMC Surgery BMC Surgery, Vol 21, Iss 1, Pp 1-10 (2021) |
| DOI: | 10.21203/rs.3.rs-94522/v1 |
| Popis: | Background:Guidelines do not recommend surgery for patients with oligometastatic disease from esophagogastric adenocarcinoma (EGAC), although some studies suggest a more favourable survival. We analyzed the outcome of oligometastatic EGAC receiving FLOT chemotherapy followed by surgery. Methods:The data of patients with either pre-therapeutic, post-neoadjuvant or intraoperative clinical diagnosis of oligometastatic EGAC were extracted from a prospective database of the 2009-2018 treatment period. 48 consecutive patients were identified with oligometastatic disease, who underwent perioperative chemotherapy plus surgery. We retrospectively analyzed surgical outcome and overall survival. Results:The overall 5-year survival was 18 %. 12 patients with pre-therapeutic oligometastatic EGAC, who had no histologic vital tumor evidence of metastases after surgery had a survival rate of 48 % compared to an 11 % 5-year survival rate of 36 patients, who had histologic vital tumor metastatic evidence after FLOT chemotherapy and surgical resection (p=0.012). The survival rates after R0, R1 and R2 (non-resected metastases) resection were 21 % (n=33), 0 % (n=4) and 17 % (n=11), respectively (p=0.273).Conclusion:Oligometastatic EGAC is associated with poor overall survival even after complete resection of all tumor manifestations. The subgroup of patients with a complete pathohistologic response of metastatic lesions to neoadjuvant FLOT shows 5-year survival rates similar to non-metastatic EGAC. Trial registration: Not applicable |
| Databáze: | OpenAIRE |
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