Abstract 1438P
Background
FLOT4 clinical trial found that perioperative chemotherapy with FLOT (fluorouracil plus leucovorin, oxaliplatin, and docetaxel) was associated with improved overall survival and recorded a higher proportion of patients who undergo surgery with increased R0 resection rate. East Sussex Healthcare trust (ESHT) has quickly updated the management of locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma following this publication and FLOT chemotherapy is the current standard of treatment in our trust. The study was aimed to compare the outcome of neoadjuvant FLOT chemotherapy among patients in ESHT with FLOT4 trial.
Methods
This retrospective study included patients with resectable gastro-oesophageal junction (GEJ) cancer treated with neoadjuvant FLOT chemotherapy from October 2017 to January 2019. Data from the hospitals across the East Sussex region were trawled through various online records. FLOT4 clinical trial outcome was used to compare our local data.
Results
This study included 31 patients, 30 males, and 1 female. 24 of them had oesophageal cancer and the remaining had gastric cancer. The majority of the patients were in the age group of 60-69. All 31 (100%) patients completed 4 cycles of FLOT chemotherapy vs 90% in FLOT4. Of 31, 84% (26) underwent successful surgery which is lower compared to the FLOT4 trial of 97%. Only 58% (18) patients had a margin-free resection compared vs FLOT4 study of 84%. Post-operatively, a similar percentage of patients completed adjuvant FLOT therapy (42% vs 46%) in both studies. 23% (7) of our patients, unfortunately, have passed away including 4% (1) who underwent surgery. This 1 death occurred within 30 days of the surgery vs 6 within 30-days deaths recorded in FLOT4. A significantly lower rate of complications post-operatively recorded in this study, 15% vs 55%.
Conclusions
Although all our patients completed the allocated cycles of FLOT neoadjuvant therapy, we found a lower number of patients who actually underwent surgery with margin-free resection. Our study recorded lower post-operative mortality (both 30- and 90-days). Although the FLOT4 study had a higher mortality rate, given our study is still ongoing, we are unable to comment on it until our study has completed.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.