2025-03-132025-03-132024-03-15VIEIRA, Ana Gabrielle de Lucena; SOUZA, João Vitor Duarte de. Quimioterapia perioperatória no tratamento de câncer gástrico localmente avançado: uma nova perspectiva no sistema público brasileiro. Orientador: Williams Fernandes Barra. 2024. 81 f. Trabalho de Curso (Bacharelado em Medicina) - Faculdade de Medicina, Instituto de Ciências Medicas, Universidade Federal do Pará, Belém, 2024. Disponível em: https://bdm.ufpa.br/jspui/handle/prefix/7863. Acesso em:.https://bdm.ufpa.br/jspui/handle/prefix/7863Introduction: Gastric cancer is one of the neoplasms with the highest morbidity and mortality rates, thats why it necessitates the standardization of treatment strategies in the public healthcare system. Objectives: Report the experience of the oncology team at Hospital Universitário João de Barros Barreto with the FLOT protocol, from 2017 to 2023. Specifically: evaluate tolerance to chemotherapy treatment, describing the toxicity rate; characterize the clinical stages of patients, such as overall and disease-free survival; evaluate the impact of clinical and pathological staging and pathological response on the overall survival of patients and evaluate the impact of the ratio of neutrophils/lymphocytes and platelets/lymphocytes on the overall life of patients. Method: In this retrospective study, 300 medical records were evaluated, and 123 patients who underwent perioperative chemotherapy were included for analysis, with 118 of them receiving FLOT chemotherapy. Multivariate analyses were used, associating clinical, epidemiological, surgical, and pathological factors, as well as staging and outcomes. Chi-square tests, Fisher's exact test for very low counts, and Kaplan-Meier estimator for impact and overall survival analysis were employed. Results and Discussion: In this study, 65% of the patients were male and 35% were female, demonstrating an epidemiological profile similar to international literature. Regarding clinical staging (CS), 54% of patients were CS I and II, while 46% were CS III. Furthermore, 95.9% of patients initiated chemotherapy with FLOT, 114 (92%) underwent surgery, and 75 (60.97%) received adjuvant therapy. Laboratory analyses were also performed, determining two ratios: neutrophil/lymphocyte and platelet/lymphocyte, along with other laboratory indicators to correlate these factors with patient mortality. In terms of pathological response, 47% of patients progressed to ypN0 and 53% to ypN+ after neoadjuvant therapy, numbers consistent with international literature. Moreover, 14.9% of patients had a complete pathological response, and 85.1% had partial tumor regression. The median disease-free survival among ypN0 patients was 24 months, while ypN+ patients had a median of 14 months, with 50% of patients still under follow-up. Regarding deaths, 3 patients (2.44%) died due to treatment toxicities, 15 patients (13.15%) died post-surgery, and among the 123 patients, 36 (29.27%) died, while 76 (61.79%) are alive, and 11 (8.94%) were lost to follow-up. Conclusion: The epidemiological profile of patients in this study is similar to that of international literature. The platelet/lymphocyte ratio was shown to be a predictor of survival The rate of complete pathological response was 14.9%. Patients with complete pathological response, ypT0ypN0, who were discharged from the surgical procedures, are alive and disease free. The median overall survival of patients in this study was 23,6 months.Acesso AbertoQuimioterapia perioperatóriaCâncer gástricoResposta patológicaPerioperative chemotherapyGastric cancerPathological responseCNPQ::CIENCIAS MEDICAS::MEDICINATrabalho de Curso - Graduação - Monografia