{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:00:46Z","timestamp":1785117646219,"version":"3.55.0"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: This study aimed to evaluate the effects of 24 h versus 46 h continuous 5-fluorouracil (5-FU) infusion durations on pathological response, progression-free survival (PFS), and overall survival (OS) in patients with gastric and gastroesophageal junction adenocarcinoma receiving a perioperative FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) regimen. Materials and Methods: A total of 300 patients who received a perioperative FLOT regimen were retrospectively analyzed. The patients were divided into two groups as those receiving 24 h and 46 h continuous 5-FU infusion. Clinicopathological characteristics were compared. Survival analyses were evaluated using the Kaplan\u2013Meier method. Factors affecting pathological response were analyzed by logistic regression, and factors affecting survival were examined by Cox regression analysis. Results: Pathological response rates were found to be significantly higher in patients receiving 46 h 5-FU infusion (multivariate analysis: OR = 2.884; 95% CI: 1.619\u20135.138; p &lt; 0.001). The probability of pathological response was found to be significantly lower in patients with baseline cT4 and advanced nodal stage. Median OS times were 41.23 months and 33.73 months in the 24 h and 46 h groups, respectively, with no significant difference detected between the groups (p = 0.371). In contrast, median PFS time was significantly longer in the 24 h group (38.47 months vs. 18.00 months; p &lt; 0.001). However, in multivariate analysis, 5-FU infusion duration could not be demonstrated as an independent prognostic factor for PFS. Moderately and poorly differentiated tumors and an increased number of positive lymph nodes were found to be independent risk factors for progression. Conclusions: Although 46 h 5-FU infusion in the perioperative FLOT regimen was associated with a higher pathological response rate, this advantage was not reflected in survival outcomes. It is considered that the observed difference in PFS may stem from the clinicopathological heterogeneity between the groups. Prospective randomized studies are needed to determine the optimal 5-FU infusion duration.<\/jats:p>","DOI":"10.3390\/medicina62081444","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:26:23Z","timestamp":1785115583000},"page":"1444","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of 24 Versus 46-Hour 5-FU Infusion Durations in the Perioperative FLOT Therapy for Gastric Cancer"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5928-0447","authenticated-orcid":false,"given":"Savas","family":"Gokcek","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Kahramanmara\u015f Necip Faz\u0131l City Hospital, 46040 Kahramanmara\u015f, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pervin","family":"Can Sanc\u0131","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Kocaeli University, 41380 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4919-266X","authenticated-orcid":false,"given":"An\u0131l","family":"Karakayal\u0131","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Kocaeli University, 41380 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5638-1816","authenticated-orcid":false,"given":"Emine Bihter","family":"Eniseler","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Celal Bayar University, 45030 Manisa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4288-9632","authenticated-orcid":false,"given":"Melis","family":"K\u0131l\u0131nc","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, 35340 \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0684-8710","authenticated-orcid":false,"given":"Ozge","family":"Yetginoglu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, 35340 \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0937-0468","authenticated-orcid":false,"given":"Ali","family":"Kalem","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Gaziantep University, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caglar","family":"Koseoglu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gaziantep City Hospital, 27310 Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9317-942X","authenticated-orcid":false,"given":"Ferhat","family":"Ekinci","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Celal Bayar University, 45030 Manisa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8596-4233","authenticated-orcid":false,"given":"Mehmet","family":"Uzun","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Tepecik Training and Research Hospital, University of Health Sciences, 35340 \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7083-8517","authenticated-orcid":false,"given":"Huseyin Salih","family":"Semiz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, 35340 \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9124-6123","authenticated-orcid":false,"given":"Ilkay Tugba","family":"Unek","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Dokuz Eyl\u00fcl University, 35340 \u0130zmir, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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