ArticleJournal of clinical medicine2020
Pattern of Recurrence and Patient Survival after Perioperative Chemotherapy with 5-FU, Leucovorin, Oxaliplatin and Docetaxel (FLOT) for Locally Advanced Esophagogastric Adenocarcinoma in Patients Treated Outside Clinical Trials.
Article in Journal of clinical medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Lack of Oncological Benefit from Bursectomy in Radical Gastrectomy: A Systematic Review.Visceral medicine · 2021Pooled it
- Trial
- Clinical implications of using both fluoropyrimidine and paclitaxel in patients with severe peritoneal metastasis of gastric cancer: A post hoc study of JCOG1108/WJOG7312G.Cancer medicine · 2021Trial
- First-Line Treatment After Perioperative FLOT in Recurrent Gastric and Gastroesophageal Junction Cancer: A Turkish Oncology Group (TOG) Multicenter Real-World Analysis.Medicina (Kaunas, Lithuania) · 2026Article
- Assessment of methylated BCAT1 and IKZF1 circulating tumor DNA as a prognostic biomarker in esophagogastric adenocarcinomas.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- Management of gastric cancer peritoneal metastasis: International Gastric Cancer Association GCPM Working Group consensus statements.The British journal of surgery · 2026Article
- Impact of postoperative chemotherapy in patients resected for esophagogastric adenocarcinoma with major pathological response after preoperative chemotherapy: a study from the FREGAT database.Therapeutic advances in medical oncology · 2026Article
- A LODDS and PNI-based personalized prognostic model for patients with gastric cancer receiving neoadjuvant chemotherapy.Frontiers in nutrition · 2026Article
- Incidence of peritoneal carcinomatosis after perioperative FLOT chemotherapy in gastric cancer. single-center analysis in Kazakhstan.Frontiers in oncology · 2026Article
- Review
- Real-life effectiveness of FLOT in resectable gastric cancer: existing challenges.Drugs in context · 2025Article
- Report from the 25th Annual Western Canadian Gastrointestinal Cancer Consensus Conference on Gastric and Gastroesophageal Cancers, Winnipeg, Manitoba, 26-27 October 2023.Current oncology (Toronto, Ont.) · 2024Article
- Docetaxel-Based Neoadjuvant Chemotherapy Followed by En Bloc Resection for Esophageal Adenocarcinoma: A 15-Year Retrospective Analysis from a Regional Upper Gastrointestinal Cancer Network.Annals of surgical oncology · 2024Article
- Perioperative Chemotherapy for Gastro-Esophageal or Gastric Cancer: Anthracyclin Triplets versus FLOT.Cancers · 2024Article
- Patterns of Recurrence After Poor Response to Neoadjuvant Chemotherapy in Gastric Cancer and the Role for Adjuvant Radiation.Annals of surgical oncology · 2024Article
- Pattern and time point of relapse in locally advanced esophagogastric adenocarcinoma after multimodal treatment: implications for a useful structured follow-up.Journal of cancer research and clinical oncology · 2023Article
- Perioperative therapy landscape for locally advanced, resectable esophageal cancer: an updated literature review.Journal of thoracic disease · 2023Review
- Canonical Wnt Pathway Is Involved in Chemoresistance and Cell Cycle Arrest Induction in Colon Cancer Cell Line Spheroids.International journal of molecular sciences · 2023Article
- Perioperative chemotherapy with 5-FU, leucovorin, oxaliplatin, and docetaxel (FLOT) for esophagogastric adenocarcinoma: ten years real-life experience from a surgical perspective.Langenbeck's archives of surgery · 2023Article
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 5-FU, Leucovorin, Oxaliplatin and Docetaxel (FLOT) protocol provides superior oncologic results compared to other perioperative chemotherapeutic protocols for the treatment of non-metastatic esophagogastric cancer (EGAC). Survival and the pattern of recurrence of EGAC after FLOT and curative tumor resection are analyzed in a collective of patients treated outside clinical trials.
methodsTwo-hundred-seventy-seven patients with EGAC (cT3-4 and/or cN+) were treated with perioperative FLOT-chemotherapy plus curative surgery between 2009 and 2018. Data were analyzed retrospectively from a prospective database.
resultsTwo-hundred-twenty-eight patients were included in the analysis. Postoperative in-hospital mortality was 2%. The median survival was 61-months, and median recurrence-free survival was 42 months. Multivariate analysis identified postoperative nodal status and T-stage as independent predictors of improved overall and recurrence-free survival. Administration of adjuvant chemotherapy failed to be significant for overall survival but was an independent predictor of recurrence-free survival. Recurrence occurred after a median of 9 months (range 1-46 months). Eighty-nine percent of recurrence occurred during the first 24 months. The rate of local recurrence was low. After surgery for gastric cancer, the major recurrence site was peritoneal carcinomatosis (56%), while esophageal cancer recurred mostly as metastasis to distant organs (78%). The specific site of recurrence had no impact on overall survival time.
conclusionReal-life application of FLOT shows oncologic results comparable to clinical trials. Recurrence after FLOT and surgery for EGAC occurs predominantly early within the first two years after surgery and in the form of distant organ metastasis for esophageal tumors or peritoneal carcinomatosis for gastric tumors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.