Abstract 162P
Background
Gastric carcinoma (GC) has a high incidence rate of 7% in Asian countries. Perioperative FLOT has been the standard of care for potentially resectable GC and Gastro-oesophageal junction (GOJ) carcinoma. This study aims to evaluate the proportion of patients with pathological complete regression (pCR) in the primary tumor after preoperative chemotherapy.
Methods
This retrospective analysis included patients diagnosed with locally advanced, resectable GC or GOJ who received perioperative FLOT at Penang General Hospital between July 2019 and December 2023. Patient data were obtained from Departmental records.
Results
Our cohort comprised 43 patients, majority were men (69.8%) with median age of 58 years old (29-75). GOJ carcinoma made up 72% of the cohort. 35 patients (81.4%) completed preoperative FLOT, whereby 30 of them (85%) proceeded with surgical resection. Among the 30 patients who underwent surgical resection, 3 patients (10%) achieved pathological complete response (PCR), 22 patients (73%) achieved margin-free (R0) resection. The median time patients received their first chemotherapy from time of diagnosis was 6 weeks with 15 patients receiving it within 4 to 6 weeks. Postoperatively, 24 patients (55.8%) initiated adjuvant FLOT, but only 17 of them (39.5%) completed total 8 cycles perioperative FLOT. The most common grade 3 and 4 toxicities were diarrhoea in 2 (4.6%) of 43 patients, 1 (2.3%) neutropenia, 1 (2.3%) laryngospasm, 1 (2.3%) infection.
Conclusions
Our cohort obtained a PCR rate of 10%, which is lower than the 16% reported by FLOT4 trial. This discrepancy could be attributed to variables, such as patients’ tolerance to full course preoperative treatment, diagnostic and referral process to initiation of treatment. Diarrhea was our most frequent toxicity (4.6%), while FLOT4 patients had more neutropenia (52%). Our cohort observed a comparable PCR in the primary tumor with preoperative FLOT. We aim for a prospective data collection and analysis in the future.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.