P-312 Perioperative chemotherapy versus surgery alone on resectable advanced gastric cancer in a Moroccan population

Abstract

Background: Gastric cancer represents the fifth most common tumor and the thirdleading cause of cancer-related death worldwide. The results of surgical treatment of locally advanced gastric cancer remain generally poor due to the high rate of relapse after surgery. In the last decade, neoadjuvant chemotherapy has become the standard of care for patients with stage IB resectable advanced gastric cancer. The benefit in progression-free and overall survival was confirmed by several randomised trials and meta-analyses compared to immediate surgery. However, data in the "reallife" setting are rare. We conducted a retrospective study to clarify the question of whether this benefit is achievable under real-life conditions.Methods: Our retrospective study concerned patients with histologically-confirmed advanced gastric cancer clinical stage II-IIIc according to UICC (8th edition) treated at the University Hospital of Marrakech between January 2017 and December 2018. They received 2-4 cycles/3 weeks of neoadjuvant chemotherapy based on FLOT, FOLFOX, XELOX, EOX or 5FU-Cisplatin protocols.Results: 48 patients with a median age of 56 years were diagnosed with advanced gastric cancer. 67% of them are male were. Only 16 patients (33,3%) had received neoadjuvant chemotherapy and 19 were operated immediately (39,5%). Protocols used in perioperative were FLOT in 8 patients (50%) and FOLFOX in 4 patients (25%). The rest have received either EOX (1 patient), XELOX (2 patients) or 5FU-cisplatin (1 patient). 7 patients (43,75%) received 4 cycles of neoadjuvant chemotherapy. Side effects were represented by mycosis grade 2 in 2 patients, neutropenia grade 2 in 4 patients and only one patient had grade 3 toxicity. After neoadjuvant chemotherapy, we observed 3 cases of partial response and 4 of stable disease. 5 patients (31,25%) underwent surgery (R0 in all cases) by total gastrectomy and D2 lymphadenectomy. 68,42% of the group who did not receive neoadjuvant chemotherapy, were treated by concomitant chemoradiotherapy. The median overall survival in the neoadjuvant group was 21 months compared to only 12 in the second group. Conclusion:Despite the small number of patients treated, our analysis showed that selected patients with locally advanced adenocarcinoma can be safely managed with perioperative chemotherapy in daily clinical practice and our results confirm the survival benefit of perioperative treatment. abstracts Annals of Oncology Volume 31 -Issue S3 -2020 S191