Characteristic and Clinical Outcomes of Localized Gastric Cancer: A Real-World Experience

Gastric and gastroesophageal junction (G/GEJ) cancers, with their poor prognosis, pose management challenges. Treatments like perioperative chemotherapy, neoadjuvant chemoradiotherapy, and adjuvant chemotherapy aim to improve outcomes. The 5-fluorouracil, leucovorin, oxaliplatin, docetaxel (FLOT) regimen has shown promise in enhancing survival. The effectiveness of prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) and intra-operative radiotherapy (IORT) is still being studied. We investigated the roles of different prognostic factors and therapeutic interventions in patients with localized G/GEJ.

A retrospective study of 65 patients diagnosed with localized G/GEJ cancer and treated at a tertiary cancer center from January 2018 to December 2022.

Over a median follow-up of 23 months (range: 15.2-37.0 months), we observed a median progression-free survival (PFS) of 20 months (95% confidence interval [CI]: 8.5-31.5) and a median overall survival (OS) of 35.0 months (95% CI: 19.5-50.5). Univariate analysis revealed no statistically significant differences in OS across treatment subgroups. Notably, patients without prophylactic HIPEC/IORT and those treated with perioperative 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) showed numerically longer PFS and OS than their counterparts.

Our study supports the effectiveness of perioperative chemotherapy in localized gastric cancer, aligning with international data. However, it does not confirm FLOT's superiority over FOLFOX or the benefit of adjuvant HIPEC/IORT in these patients.