Prognostic factors of perioperative FLOT regimen in operable gastric and gastroesophageal junction tumors: real-life data (Turkish Oncology Group)
| Autor: | CİHAN EROL, ABDULLAH SAKİN, TUĞBA BAŞOĞLU TÜYLÜ, ERCAN ÖZDEN, DEVRİM ÇABUK, MUTLU DOĞAN, ÖMÜR BERNA ÇAKMAK ÖKSÜZOĞLU, HASAN ÇAĞRI YILDIRIM, İREM ÖNER, MELEK KARAKURT ERYILMAZ, ÖZGECAN DÜLGAR, DİNÇER AYDIN, NESLİHAN ÖZYURT, MİRAÇ ÖZEN, İLHAN HACIBEKİROĞLU |
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| Přispěvatelé: | Erol C., Sakin A., Başoglu T., Özden E., ÇABUK D., Doğan M., Öksüzoğlu B., YILDIRIM H. Ç. , Öner İ., Karakurt Eryilmaz M., et al. |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Survival
retrospective study very elderly diarrhea gastroesophageal junction thrombocytopenia Sağlık Bilimleri Fundamental Medical Sciences Clinical Medicine (MED) Nomogram fluorouracil TIP GENEL & DAHİLİ stomach adenocarcinoma docetaxel Klinik Tıp (MED) prognostic factor MEDICINE GENERAL & INTERNAL disease free survival Cancer stomach cancer Klinik Tıp adult Platelet General Medicine anemia Tıp adjuvant chemotherapy aged female histopathology Medicine neoadjuvant chemotherapy platelet lymphocyte ratio folinic acid overall survival Temel Tıp Bilimleri Adenocarcinoma Genel Tıp cancer prognosis Article perioperative treatment histology male Health Sciences Chemotherapy follow up neutropenia human lymphocyte count Neutrophil-Lymphocyte Ratio albumin FLOT chemotherapy gastric cancer carcinoembryonic antigen cancer staging neutrophil count oxaliplatin CLINICAL MEDICINE platelet count major clinical study stomatitis CA 19-9 antigen drug efficacy neutrophil lymphocyte ratio GEJ tumor tumor marker Surgery fatigue neuropathy blood cell count |
| Popis: | Background/aim: 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. Materials and 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. Conclusion: 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. © TÜBİTAK. |
| Databáze: | OpenAIRE |
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