Benefit of postoperative chemotherapy in operated gastric or gastro-esophageal junction adenocarcinoma ypT0-3N0 : a retrospective and multicenter AGEO study

Abstract

Background Standard therapy in gastric or gastro-esophageal junction (GOJ) adenocarcinoma is perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel (FLOT regimen). FLOT offers significant histological response rates. The objective of our study was to evaluate the benefit of postoperative chemotherapy on recurrence free survival (RFS) in operated gastric or gastro-esophageal junction adenocarcinoma ypT0-3N0. Materials and Methods. This retrospective mulicenter study included patients with gastric or GOJ adenocarcinoma ypT0-3N0 treated with preoperative FLOT-type chemotherapy and operated between January 2017 and January 2022. Patients were divided into two groups: a group without postoperative chemotherapy (monitoring group) and a group with postoperative chemotherapy (chemotherapy group). Primary criterion was RFS. Secondary criterion was overall survival (OS). Results A total of 123 patients were included, 107 in the post chemotherapy group and 16 in the monitoring group. Patients in the chemotherapy group were younger (59 vs. 67 years) and had had less preoperative chemotherapy dose reduction (29 vs. 43,7%). There was no significant difference between the 2 groups concerning RFS (p = 0,87) and OS (p = 0,93). Conclusion Our study suggests that postoperative chemotherapy does not improve survival in gastric or GOJ adenocarcinoma following surgery and 4 cycles of preoperative FLOT. Our study paves the way for a prospective randomized trial focusing on the usefulness of 4 cycles of post operative FLOT. Publication type : MeSH : Academic Dissertation