“14th International Gastrointestinal Cancers Conference”, İstanbul, Türkiye, 28 Kasım - 01 Aralık 2024, ss.10-11, (Özet Bildiri)
Introduction: Perioperative FLOT chemotherapy regimen
has become a standard of care in the gastric cancer treatment.
FLOT promises efficacy in downstaging as well as survival benefit. It is not clear whom to benefit more from this regimen. Our
study is aimed to elucidate this obscurity.Introduction: Perioperative FLOT chemotherapy regimen
has become a standard of care in the gastric cancer treatment.
FLOT promises efficacy in downstaging as well as survival ben-
efit. It is not clear whom to benefit more from this regimen. Our
study is aimed to elucidate this obscurity.
Method: This retrospective study evaluated the patients were
diagnosed and treated for locally advanced gastric carcinoma
between 2017 and 2024. The study included patients who re-
ceived neoadjuvant chemotherapy followed by surgery, with
clinicopathologic and laboratory data being analyzed. The data
analyzed as immune-inflammatory markers obtained from the
parameters at the time of diagnosis. Besides pathologic markers
were procured from both diagnostic biopsy material or postop-
erative materiaIntroduction: Perioperative FLOT chemotherapy regimen
has become a standard of care in the gastric cancer treatment.
FLOT promises efficacy in downstaging as well as survival ben-
efit. It is not clear whom to benefit more from this regimen. Our
study is aimed to elucidate this obscurity.
Method: This retrospective study evaluated the patients were
diagnosed and treated for locally advanced gastric carcinoma
between 2017 and 2024. The study included patients who re-
ceived neoadjuvant chemotherapy followed by surgery, with
clinicopathologic and laboratory data being analyzed. The data
analyzed as immune-inflammatory markers obtained from the
parameters at the time of diagnosis. Besides pathologic markers
were procured from both diagnostic biopsy material or postop-
erative materiaIntroduction: Perioperative FLOT chemotherapy regimen
has become a standard of care in the gastric cancer treatment.
FLOT promises efficacy in downstaging as well as survival ben-
efit. It is not clear whom to benefit more from this regimen. Our
study is aimed to elucidate this obscurity.
Method: This retrospective study evaluated the patients were
diagnosed and treated for locally advanced gastric carcinoma
between 2017 and 2024. The study included patients who re-
ceived neoadjuvant chemotherapy followed by surgery, with
clinicopathologic and laboratory data being analyzed. The data
analyzed as immune-inflammatory markers obtained from the
parameters at the time of diagnosis. Besides pathologic markers
were procured from both diagnostic biopsy material or postop-
erative materiaIntroduction: Perioperative FLOT chemotherapy regimen
has become a standard of care in the gastric cancer treatment.
FLOT promises efficacy in downstaging as well as survival ben-
efit. It is not clear whom to benefit more from this regimen. Our
study is aimed to elucidate this obscurity.
Method: This retrospective study evaluated the patients were
diagnosed and treated for locally advanced gastric carcinoma
between 2017 and 2024. The study included patients who re-
ceived neoadjuvant chemotherapy followed by surgery, with
clinicopathologic and laboratory data being analyzed. The data
analyzed as immune-inflammatory markers obtained from the
parameters at the time of diagnosis. Besides pathologic markers
were procured from both diagnostic biopsy material or postop-
erative materiaIntroduction: Perioperative FLOT chemotherapy regimen
has become a standard of care in the gastric cancer treatment.
FLOT promises efficacy in downstaging as well as survival ben-
efit. It is not clear whom to benefit more from this regimen. Our
study is aimed to elucidate this obscurity.
Method: This retrospective study evaluated the patients were
diagnosed and treated for locally advanced gastric carcinoma
between 2017 and 2024. The study included patients who re-
ceived neoadjuvant chemotherapy followed by surgery, with
clinicopathologic and laboratory data being analyzed. The data
analyzed as immune-inflammatory markers obtained from the
parameters at the time of diagnosis. Besides pathologic markers
were procured from both diagnostic biopsy material or postop-
erative material.
Results: A total of 35 patients were included, with a mean age
at diagnosis of 64.63 ± 8.62 years; of 24 (68.6%) were male.
The tumor was most frequently located in the corpus (42.9%).
Only 3 (8.6%) patients had HER2 amplification. All patients
were treated with FLOT regimen, which includes docetaxel, ox-
aliplatin, leucovorin, and 5-fluorouracil. The median number of
treatment cycles was 4 (min 1 – max 4). Eleven (31.4%) pa-
tients experienced toxicity leading to dose reduction and only
3 (8.6%) patients did not complete the full four cycles of FLOT.
The median number of lymph nodes dissected was 29.5 (min
9 – max 61) while half of the patients underwent D2 lymph node
dissection (more than 30 lymph nodes dissected). After surgery,
27 (77.1%) patients continued with adjuvant FLOT therapy, 3
patients (8.6%) received FOLFOX and 5 patients (14.3%) did
not received any adjuvant treatment. Recurrence or progression
occurred in 15 (42.9%) patients following adjuvant therapy, with
a median time to progression (TTP) of 9.1 months. The medi-
an overall (OS) survival for the entire cohort was 33.0 months,
while patients with recurrence or progression have significantly
shorter OS (21.35 months vs NR, p<0.001). The mean prog-
nostic nutritional index (PNI) was 49.9, and patients with a PNI
of 49.9 or higher had a significantly longer OS (56,57 months
vs. 24,93 months, p= 0.022). While the mean value of lympho-
cyte-to-monocyte ratio (LMR) was 3.44, patients with a higher
LMR (>3.44) had longer OS (56,57 months vs 25,39 months,
p= 0.44). Other immune inflammatory markers (NLR, PLR,
BUN/creatinine ratio, De-Ritis, ALBI score) and tumor markers
(CEA and Ca 19-9) as well as age, sex, tumor localization, D2
dissection status, and dose reduction during neoadjuvant thera-
py were not statistically significant in terms of neoadjuvant treat-
ment completion rate, DFS, TTP, or OS (p> 0.05).
Conclusion: Although the sample size is small, higher PNI
and LMR values were associated with significantly improved out-
comes in patients with locally advanced gastric adenocarcinoma
receiving the neoadjuvant FLOT regimen
