Real life experience of patients with locally advanced gastric and

Abstract

Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results.

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[Sakin, Abdullah] Yuzuncu Yil Univ, Med Oncol, Fac Med, Van, Turkey.

[Erol, Cihan; Sendur, Mehmet Ali] Ankara Yildirim Beyazit Universtiy, Med Oncol, Ankara, Turkey.

[Ozden, Ercan; cabuk, Devrim] Kocaeli Univ, Med Oncol, Fac Med, Kocaeli, Turkey.

[Cilbir, Ebru] Diskapi Training & Res Hosp, Med Oncol, Ankara, Turkey.

[Tataroglu ozyukseler, Deniz; Ayhan, Murat] Kartal Dr LutfiKirdar Training & Res Hosp, Med Oncol, Istanbul, Turkey.

[Dogan, Mutlu; Oksuzoglu, Berna] Ankara DrAbdurrahman Yurtaslan Oncol Training & R, Med Oncol, Ankara, Turkey.

[Eryilmaz, Melek Karakurt] Necmettin Erbakan Univ Sch Med, Med Oncol, Konya, Turkey.

[Er, Ozlem; Tasci, Elif Senocak] Acibadem Mehmet Ali Aydinlar Univ, Med Oncol, Sch Med, Istanbul, Turkey.

[Ozyurt, Neslihan] Giresun Educ & Res Hosp, Med Oncol, Giresun, Turkey.

[Dulgar, Ozgecan] Istanbul Medeniyet Univ, Goztepe Training & Res Hosp, Med Oncol, Istanbul, Turkey.

[Ozen, Mirac; Hacibekiroglu, Ilhan] Sakarya Univ, Med Oncol, Fac Med, Sakarya, Turkey.

[Oner, Irem] Konya City Hosp, Med Oncol, Konya, Turkey.

[Bekmez, Esma Turkmen] Derince Res & Training Hosp, Med Oncol, Kocaeli, Turkey.

[Cagri Yildirim, Hasan; Yalcin, Suayib] Hacettepe Univ, Med Oncol, Sch Med, Ankara, Turkey.

[Paydas, Semra] Cukurova Univ, Sch Med, Med Oncol, Adana, Turkey.

[Yekeduz, Emre] Ankara Univ, Sch Med, Med Oncol, Ankara, Turkey.

[Aksoy, Asude] Firat Univ, Fac Med, Med Oncol, Elazig, Turkey.

[Ozcelik, Melike; Oyman, Abdilkerim] Umraniye Training & Res Hosp, Med Oncol, Istanbul, Turkey.

[Almuradova, Elvina; Karabulut, Bulent] Ege Univ, Sch Med, Med Oncol, Izmir, Turkey.

[Demir, Nazan; Dincer, Murat] Eskisehir Osmangazi Univ, Sch Med, Med Oncol, Eskisehir, Turkey.

[Ozdemir, Nuriye] Gazi Univ, Sch Med, Med Oncol, Ankara, Turkey.

[Erdem, Dilek] VM Med Pk Samsun Hosp, Med Oncol, Istanbul, Turkey.

[Ak, Naziye] Istanbul Univ, Med Oncol, Istanbul, Turkey.

[Inal, Ali] Mersin City Hosp, Med Oncol, Mersin, Turkey.

[Salim, Derya Kivrak] Antalya Training & Res Hosp, Med Oncol, Antalya, Turkey.

[Deniz, Gulhan Ipek] Sisli Hamidiye Etfal Training & Res Hosp, Med Oncol, Istanbul, Turkey.

[Sakalar, Teoman] Necip Fazil City Hosp, Med Oncol, Kahramanmaras, Turkey.

[Gulmez, Ahmet] Inonu Univ, Med Oncol, Elazig, Turkey.

[Kacan, Turgut] Bursa High Specialized Educ & Res Hosp, Med Oncol, Bursa, Turkey.

[Ozdemir, Ozlem] Izmir Bozyaka Res & Training Hosp, Med Oncol, Izmir, Turkey.

[Alan, Ozkan] Tekirdag State Hosp, Med Oncol, Tekirdag, Turkey.

[Unal, Caglar] Florance Nightingale Hosp, Med Oncol, Istanbul, Turkey.

[Karakas, Yusuf] Bodrum Acibadem Hosp, Med Oncology, Mugla, Turkey.

[Turhal, Serdar] Anadolu Saglik Merkezi Anadolu Hlth Ctr, Med Oncol, Istanbul, Turkey.