{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T20:58:10Z","timestamp":1785358690784,"version":"3.55.0"},"reference-count":37,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Locally advanced gastroesophageal adenocarcinomas commonly relapse early with peritoneal disease, suggesting that a subset of patients harbor occult peritoneal micrometastases at diagnosis. These patients may benefit from peritoneal-directed therapy in the perioperative setting. To facilitate patient selection and evaluation of such therapies, we derived, validated, and compared prediction models for peritoneal recurrence after fluorouracil, leucovorin, oxaliplatin and docetaxel (FLOT)\u2013based multimodality treatment using pre- and post-treatment clinicopathologic predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A total of 2,240 patients from the international Survival and Patterns of Care in the Era-FLOT registry were analyzed. Using Fine-Gray competing-risk regression, patients who developed peritoneal recurrence were compared with those with nonperitoneal recurrence, those who died without recurrence, and those who remained disease-free at follow-up. Pre- and post-treatment variables, obtained at staging and post-FLOT\/surgery, respectively, were used to construct pre- and post-treatment predictive models of peritoneal recurrence, with internal validation using bootstrap optimism correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Peritoneal recurrence was the most frequent (41% of all recurrences) and earliest site of disease relapse (median 9.8\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      11.4 months,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .024) and was associated with poorer postrecurrence (median 4.4\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      9.8 months,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and overall (median 17.0\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      24.3 months,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) survival compared with nonperitoneal recurrence. Six pretreatment and eight post-treatment variables independently predicted peritoneal recurrence and were incorporated into pre- and post-treatment models, respectively. At 12, 24, and 36 months postsurgery, both models demonstrated good discriminatory performance in predicting peritoneal relapse with comparable accuracy and risk calibration profiles. Decision curve analysis found that both models were superior to treat-none and treat-all approaches, highlighting their potential clinical utility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Peritoneal recurrence remains a common and important problem. We derived pre- and post-treatment prediction models for peritoneal recurrence, also available as web-based calculators. These tools can clinically prognosticate and may advance peritoneal-directed therapies for high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-25-01145","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T19:59:10Z","timestamp":1785355150000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Pre- and Post-Treatment Predictive Models of Peritoneal Recurrence After Fluorouracil, Leucovorin, Oxaliplatin, and Docetaxel-Chemotherapy and Surgery: An International Study"],"prefix":"10.1200","volume":"10","author":[{"given":"Margaret M.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Box Hill Hospital, Box Hill, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1490-0547","authenticated-orcid":true,"given":"Darren J.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Austin Health, Heidelberg, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katheryn","family":"Hall","sequence":"additional","affiliation":[{"name":"Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia"},{"name":"Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia"},{"name":"Division of Surgery, Anaesthesia and Procedural Medicine, Upper Gastrointestinal Surgery Unit, Austin Hospital, Heidelberg, VIC, Australia"},{"name":"Department of Surgery, Victorian Interventional Research and Trials Unit, University of Melbourne, Austin Precinct, Heidelberg, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cuong P.","family":"Duong","sequence":"additional","affiliation":[{"name":"Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David I.","family":"Watson","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Flinders University, Flinders, SA, Australia"},{"name":"Department of Surgery, Flinders Medical Centre, Flinders, SA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9373-2662","authenticated-orcid":true,"given":"Claire L.","family":"Donohoe","sequence":"additional","affiliation":[{"name":"Upper Gastrointestinal Surgery Unit, St James Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Bright","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Flinders University, Flinders, SA, Australia"},{"name":"Department of Surgery, Flinders Medical Centre, Flinders, SA, 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