FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer
Background. The prognosis of patients with advanced gastric cancer remains unsatisfactory, highlighting the need for improved therapeutic strategies. We analyzed 23 resectable advanced gastric cancer patients who received FLOT followed by laparoscopic gastrectomy with D2 lymphadenectomy to evaluate...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2020/1702823 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832555127339220992 |
|---|---|
| author | Shun Zhang Dongyi Yan Qi Sun Tao Du Dongliang Cao Yao Yang Biao Yuan Haiqiang Li Xiaohua Jiang Chun Song |
| author_facet | Shun Zhang Dongyi Yan Qi Sun Tao Du Dongliang Cao Yao Yang Biao Yuan Haiqiang Li Xiaohua Jiang Chun Song |
| author_sort | Shun Zhang |
| collection | DOAJ |
| description | Background. The prognosis of patients with advanced gastric cancer remains unsatisfactory, highlighting the need for improved therapeutic strategies. We analyzed 23 resectable advanced gastric cancer patients who received FLOT followed by laparoscopic gastrectomy with D2 lymphadenectomy to evaluate the efficacy and safety. Methods. Patients aged 18–75 years with gastric adenocarcinoma (stage cT3–4 and/or N + M0) underwent neoadjuvant FLOT therapy (four preoperative and four postoperative 2-week cycles) at Shanghai East Hospital. Laparoscopic gastrectomy was scheduled 3-4 weeks after completion of the last cycle of preoperative chemotherapy. The type of surgical procedure was determined by the location and extent of the primary tumor. Results. 23 patients were reviewed in the study. 20 patients (81.2%) received four courses of FOLT therapy, while 3 patients (18.8%) received three courses of treatment. There were 3 (13.0%) complete responses, 13 (56.5%) partial responses, 4 (26.1%) of stable disease, and 1 (4.3%) of progressive disease. The clinical efficacy response rate was 69.6%. The R0 resection rate was 91.3%. Only one patient exhibited grade III postoperative complications. The pathologic complete remission was 13%. The common grade 3/4 adverse events from chemotherapy were leucopenia (17.4%), neutropenia (30.4%), anemia (13%), anorexia (13%), and nausea (17.4%). Postoperative complications occurred in 5 patients (26.1%). There was no treatment-related mortality or reoperation. The most reason for not completing chemotherapy was the patient’s request. Conclusions. These findings suggest that FLOT neoadjuvant chemotherapy, followed by laparoscopic D2 gastrectomy, is effective and safe in advanced, resectable advanced gastric cancer. |
| format | Article |
| id | doaj-art-b67eab4efa7841d58d22ed46ee0a647f |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-b67eab4efa7841d58d22ed46ee0a647f2025-02-03T05:49:32ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972020-01-01202010.1155/2020/17028231702823FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric CancerShun Zhang0Dongyi Yan1Qi Sun2Tao Du3Dongliang Cao4Yao Yang5Biao Yuan6Haiqiang Li7Xiaohua Jiang8Chun Song9Department of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Colorectal Surgery, Jiangyin People’s Hospital, Jiangyin, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaDepartment of Gastrointestinal Surgery, Shanghai East Hospital (East Hospital Affiliated to Tongji University), Shanghai, ChinaBackground. The prognosis of patients with advanced gastric cancer remains unsatisfactory, highlighting the need for improved therapeutic strategies. We analyzed 23 resectable advanced gastric cancer patients who received FLOT followed by laparoscopic gastrectomy with D2 lymphadenectomy to evaluate the efficacy and safety. Methods. Patients aged 18–75 years with gastric adenocarcinoma (stage cT3–4 and/or N + M0) underwent neoadjuvant FLOT therapy (four preoperative and four postoperative 2-week cycles) at Shanghai East Hospital. Laparoscopic gastrectomy was scheduled 3-4 weeks after completion of the last cycle of preoperative chemotherapy. The type of surgical procedure was determined by the location and extent of the primary tumor. Results. 23 patients were reviewed in the study. 20 patients (81.2%) received four courses of FOLT therapy, while 3 patients (18.8%) received three courses of treatment. There were 3 (13.0%) complete responses, 13 (56.5%) partial responses, 4 (26.1%) of stable disease, and 1 (4.3%) of progressive disease. The clinical efficacy response rate was 69.6%. The R0 resection rate was 91.3%. Only one patient exhibited grade III postoperative complications. The pathologic complete remission was 13%. The common grade 3/4 adverse events from chemotherapy were leucopenia (17.4%), neutropenia (30.4%), anemia (13%), anorexia (13%), and nausea (17.4%). Postoperative complications occurred in 5 patients (26.1%). There was no treatment-related mortality or reoperation. The most reason for not completing chemotherapy was the patient’s request. Conclusions. These findings suggest that FLOT neoadjuvant chemotherapy, followed by laparoscopic D2 gastrectomy, is effective and safe in advanced, resectable advanced gastric cancer.http://dx.doi.org/10.1155/2020/1702823 |
| spellingShingle | Shun Zhang Dongyi Yan Qi Sun Tao Du Dongliang Cao Yao Yang Biao Yuan Haiqiang Li Xiaohua Jiang Chun Song FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer Canadian Journal of Gastroenterology and Hepatology |
| title | FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer |
| title_full | FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer |
| title_fullStr | FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer |
| title_full_unstemmed | FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer |
| title_short | FLOT Neoadjuvant Chemotherapy Followed by Laparoscopic D2 Gastrectomy in the Treatment of Locally Resectable Advanced Gastric Cancer |
| title_sort | flot neoadjuvant chemotherapy followed by laparoscopic d2 gastrectomy in the treatment of locally resectable advanced gastric cancer |
| url | http://dx.doi.org/10.1155/2020/1702823 |
| work_keys_str_mv | AT shunzhang flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT dongyiyan flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT qisun flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT taodu flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT dongliangcao flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT yaoyang flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT biaoyuan flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT haiqiangli flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT xiaohuajiang flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer AT chunsong flotneoadjuvantchemotherapyfollowedbylaparoscopicd2gastrectomyinthetreatmentoflocallyresectableadvancedgastriccancer |