Evidence map›Paper›PMID 36763220›Full record

ArticleLangenbeck's archives of surgery2023

Perioperative chemotherapy with 5-FU, leucovorin, oxaliplatin, and docetaxel (FLOT) for esophagogastric adenocarcinoma: ten years real-life experience from a surgical perspective.

Leila Sisic, Nerma Crnovrsanin, Henrik Nienhueser, Jin-On Jung, Sabine Schiefer, Georg Martin Haag, Thomas Bruckner, Martin Schneider, Beat P Müller-Stich, Markus W Büchler and 1 more

Abstract read
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In one paragraph

Article in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Leila Sisic *Department of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Nerma Crnovrsanin *Department of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Henrik NienhueserDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Jin-On JungDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Sabine SchieferDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Georg Martin HaagDepartment of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, 69120, Heidelberg, Germany.
Thomas BrucknerInstitute for Medical Biometry (Imbi), University Hospital Heidelberg, 69120, Heidelberg, Germany.
Martin SchneiderDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Beat P Müller-StichDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Markus W BüchlerDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany.
Thomas SchmidtDepartment of Surgery, University Hospital Heidelberg, 69120, Heidelberg, Germany. Thomas.Schmidt1@uk-koeln.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAccording to the results of FLOT4 trial, perioperative FLOT chemotherapy improved overall survival (OS) in locally advanced, resectable esophagogastric adenocarcinoma (EGA) compared to perioperative ECF/ECX. We report real-life data 10 years after introduction of perioperative FLOT at our institution.

methodsSurvival of 356 consecutive EGA patients (cT3/4 and/or cN + and/or cM1) who underwent curative surgical resection was retrospectively analysed from a prospective database. A total of 263 patients received preoperative chemotherapy according to FLOT protocol and 93 patients received an epirubicin/platinum/5FU-based regimen (EPF). Propensity score matching (PSM) according to pretretment characteristics was performed to compensate for heterogeneity between groups.

resultsMedian OS did not differ between groups (FLOT/EPF 52.1/46.4 months, p = 0.577). After PSM, survival was non-significantly improved after FLOT compared to EPF (median OS not reached/46.4 months, p = 0.156). Perioperative morbidity and mortality did not differ between groups. Histopathologic response rate was 35% after FLOT and 26% after EPF (p = 0.169). R0 resection could be achieved more frequently after FLOT than after EPF (93%/79%, p = 0.023).

conclusionOverall survival after perioperative FLOT followed by surgery is comparable to clinical trials. However, collective real-life application of FLOT failed to provide a significant survival benefit compared to EPF. In clinical reality, patient selection is triggered by age, comorbidity, tumor localization, and clinical tumor stage. Yet matched analyses support FLOT4 trial findings.

Indexed as

AdenocarcinomaEsophageal NeoplasmsStomach NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsDocetaxelEsophagogastric JunctionFluorouracilHumansLeucovorinNeoadjuvant TherapyOxaliplatinRetrospective StudiesDocetaxelFluorouracilLeucovorinOxaliplatinAdenocarcinomaEsophageal cancerGastric cancerHistopathological regressionPerioperative chemotherapy

Identifiers

PMID36763220
PMCPMC9918580

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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.