Defining two prognostic groups of metastatic gastric cancer: FLOT3 trial of the Arbeitsgemeinschaft Internistische Onkologie (AIO).

4070 Background: A prognostic model for metastatic gastric cancer has not been established yet. Methods: Pts with untreated gastric cancer were prospectively stratified into 3 groups: operable (OD), limited metastatic (LD), or extensive metastatic (ED) disease using a predefined algorithm and treated with 5-FU, oxaliplatin, leucovorin and docetaxel (FLOT). LD was defined as having all of the following: distant intra-abdominal lymph node metastases and/or a maximum of 1 organ involved in metastatic disease (distant extra-abdominal lymph node metastases were considered as 1 organ), normal serum alkaline phosphatase, < 5 liver lesions, no clinically apparent peritoneal carcinomatosis, no lymphangiosis carcinomatosa of the lung or malignant pleural effusion, and ECOG ≤ 1. All other metastatic pts were ED. Pts with OD received 4 preoperative cycles of FLOT and were operated (D2-resection) followed by 4 postoperative cycles. Pts with LD received 8 cycles with surgery allowed for complete macroscopic resection. ...