Abstract 469P
Background
GC is the third most common cause of cancer death worldwide. Surgery is the treatment of choice. The effectiveness of adjuvant or perioperative treatments is increasingly improving. Although the best treatment sequence for localized GC (LGC) has not clearly been established, the perioperative regimen with 5-fluorouracil (5FU)/leucovorin/oxaliplatin/docetaxel [FLOT] is currently the gold standard in Western countries.
Methods
Single-center retrospective study, of pt with LGC treated with surgery at Hospital Parc Taulí from 2004 to 2020. Data regarding demographic characteristics, treatment and survival outcomes were collected. Data analysis was performed using SPSS program. The primary end point was median overall survival (mOS) based on the type of complementary treatment recived. Kaplan-Meier survival curves were used for mOS analysis and the log-rank test to detect differences.
Results
The study included 266 pt. Mean age at diagnosis was 68 years. Tumors located in the gastroesophageal junction (Siewert I/II) were not included. 52.6% pts underwent surgery alone, 6% surgery plus adjuvant chemotherapy (CT) (5FU/LV)/radiotherapy (CRT), 18.8% adjuvant CT (4.5% capecitabine/oxaliplatin (CAPOX) and 18.8% mitomycin C/tegafur (MMC-T), and 22.5% received perioperative CT [13.5% docetaxel/cisplatin/5 fluorouracil/capecitabine (DCF/C) and 4.5% FLOT]. Overall mOS was 59 months (m) (95% CI 42.634 – 75.366). The mOS of pt who underwent surgery followed by CRT was 60 m, whilst those treated with adjuvant CT, either MMC-T or CAPOX, achieved mOS of 45 m and 32 m each. Perioperative strategies with DCF/C or FLOT resulted in mOS of 43 m and 45 m, respectively. No statistically significant differences were observed between the different subgroups according to the long-rank test (p-value 0.911).
Conclusions
Our cohort illustrates the substantial changes experienced in the last two decades for treating LGC in Spain. Despite the good results achieved with initial surgery and CRT, switching onto perioperative triplets with taxanes (DCF/C or FLOT) is now the treatment of choice. However, for pt resected upfront, we demonstrate that the regimen MMC-T is a feasible alternative to CAPOX and warrants further investigation.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.