Endoscopy 2021; 53(S 01): S119
DOI: 10.1055/s-0041-1724569
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Endoscopic Ultrasound Accuracy in Gastric Cancer Staging After New Standard Neoadjuvant Chemotherapy (Flot) in Comparison With Post Surgery Histology

G de Nucci
1   Astt Rhodense, Gastroenterology and Endoscopy Unit, Garbagnate Milanese (MI), Italy
,
S della Torre
2   Asst Rhodense, Oncology Unit, Rho, Italy
,
D Picascia
1   Astt Rhodense, Gastroenterology and Endoscopy Unit, Garbagnate Milanese (MI), Italy
,
N Imperatore
3   AORN Cardarelli, Gastroenterology and Endoscopy Unit, Napoli, Italy
,
ED Mandelli
1   Astt Rhodense, Gastroenterology and Endoscopy Unit, Garbagnate Milanese (MI), Italy
,
C d’Urbano
4   ASST Rhodense, General Surgery Unit, Garbagnate Milanese (MI), Italy
,
F di Nuovo
5   ASST Rhodense, Pathology Unit, Garbagnate Milanese (MI), Italy
,
A Larghi
6   Policlinico Hospital A Gemelli, Digestive Endoscopy Unit, Rome, Italy
,
R Bollina
2   Asst Rhodense, Oncology Unit, Rho, Italy
,
G Manes
7   ASST Rhodense, Gastroenterology and Endoscopy Unit, Garbagnate Milanese (MI), Italy
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    Aims Gastric cancer is one of the most common malignant tumors in the gastrointestinal tract. Neoadjuvant chemotherapy may be administered as a means of “downstaging” a locally advanced tumor prior to an attempt at curative resection. In particular, perioperative chemotherapy with FLOT improved overall survival in patients with gastric adenocarcinoma. The aim of the study was to evaluate the EUS accuracy of T and N staging of all types of respect of with surgical specimen after FLOT regimen.

    Methods We retrospectively analyzed 16 patients with diagnosis of AGC. All patient received preoperative TNM staging using EUS and CT within one month before starting chemotherapy. They underwent neoadjuvant chemotherapy (FLOT), a regimen that includes docetaxel, oxaliplatin and leucovorin with short-term infusional fluorouracil. Then patients were evaluated with another EUS examination, prior to surgery for tumor depth of invasion and lymph node involvement at our Digestive Endoscopy Unit. EUS TN stage was compared with histopathological TN stage as gold standard.

    Results In our series, at EUS the downstaging of T alone occurred in 4 patients, N alone in 3 patients, and both descriptors only in one patient; at CT the downstaging occurred only in 6 patients. EUS and CT show only a moderate level of agreement about downstaging after chemotherapy.

    Conclusions Our results showed that EUS in restaging after FLOT regimen has an adequate diagnostic accuracy on T (68.75 %) and, in particular, on N (81.25 %), if we compare EUS findings with surgery/histology, which still remains the diagnostic gold standard.

    Citation: de Nucci G, della Torre S, Picascia D et al. eP70 ENDOSCOPIC ULTRASOUND ACCURACY IN GASTRIC CANCER STAGING AFTER NEW STANDARD NEOADJUVANT CHEMOTHERAPY (FLOT) IN COMPARISON WITH POST SURGERY HISTOLOGY. Endoscopy 2021; 53: S119.


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    Publication History

    Article published online:
    19 March 2021

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