Perioperative chemotherapy with FOLFOX in resectable gastroesophageal adenocarcinoma in real life practice: An AGEO multicenter retrospective study.
OBJECTIVE
Perioperative chemotherapy with 5-fluorouracil and cisplatin, with or without epirubicin, improves overall survival in resectable gastroesophageal junction and gastric adenocarcinoma. The aim of this retrospective multicenter study was to evaluate the safety and efficacy of perioperative chemotherapy with a FOLFOX-based regimen.


METHODS
We enrolled patients with resectable gastric or gastroesophageal adenocarcinoma, who had at least 3 cycles of a pre-operative FOLFOX-based regimen. The primary end point was the feasibility of the peri-operative chemotherapy.


RESULTS
We enrolled 109 patients from 2007 to 2012 in 12 centres. Their median age was 66, 67% were men and 73% had gastric tumours. The median number of chemotherapy courses was 6 with a median of 4 pre-operative cycles and 2 post-operative cycles. Twenty-three patients received at least 8 cycles of chemotherapy. In univariate analysis, the Karnofsky index at inclusion was the only factor associated with 8 cycles of chemotherapy. An R0 resection was achieved in 100 patients (95.2%).


CONCLUSIONS
The FOLFOX-based perioperative regimen achieves favourable results in real life practice. The optimal number of chemotherapy cycle remains to be determined. FOLFOX regimen may be used as an alternative treatment option to a cisplatin-based regimen in resectable gastroesophageal adenocarcinoma. A prospective randomized trial is needed to confirm these results.
Gastroenterology and Digestive Oncology Department, Avicenne Hospital, APHP and Université Paris 13, Sorbonne Paris Cité, Bobigny, France. Electronic address: Florence.mary@avc.aphp.fr.
Florence
F
Mary
Gastroenterology and Digestive Oncology Department, Hôpital Européen George Pompidou, APHP, Paris, France.
Aziz
A
Zaanan
Digestive Oncology Department, Gustave Roussy, Villejuif, France.
Valérie
V
Boige
Gastroenterology and Digestive Oncology Department, Jean Mermoz HospitalLyon, France.
Pascal
P
Artru
Digestive Oncology Department, Institut du Cancer, Montpellier, France.
Emmanuelle
E
Samalin
Gastroenterology and Digestive Oncology Department, Cochin Hospital, APHP, Paris, France.
Romain
R
Coriat
Hepato-Gastroenterology and Digestive Oncology Department, Pitié Salpétrière Hospital, APHP, Paris, France.
Jean-Baptiste
JB
Bachet
Research and Biostatistical Department, Avicenne Hospital, APHP, Bobigny, France.
Marouane
M
Boubaya
Gastroenterology and Digestive Oncology Department, Avicenne Hospital, APHP and Université Paris 13, Sorbonne Paris Cité, Bobigny, France.
Mourad
M
Benallaoua
Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers, France.
David
D
Tougeron
Gastroenterology and Digestive Oncology Department, Saint Antoine Hospital, APHP, Paris, France.
Pauline
P
Afchain
Hepato-Gastroenterology and Digestive Oncology Department, Meaux Hospital, Meaux, France.
Christophe
C
Locher
Hepato-Gastroenterology and Digestive Oncology Department, Henri Mondor Hospital, APHP, Creteil, France.
Isabelle
I
Baumgaertner
Gastroenterology and Digestive Oncology Department, Polyclinique de Bordeaux Nord, Bordeaux, France.
Cédric
C
Lecaille
Oncology Department, Avicenne Hospital, APHP, Bobigny, France.
Gaetan
G
des Guetz
Gastroenterology and Digestive Oncology Department, Avicenne Hospital, APHP and Université Paris 13, Sorbonne Paris Cité, Bobigny, France.
Thomas
T
Aparicio
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D013505:Digestive System Surgical Procedures; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D059035:Perioperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil
FOLFOX; Gastric adenocarcinoma; Gastroesophageal adenocarcinoma; Perioperative chemotherapy