Objective To explore the therapeutic effect and prognostic value of FLOT neoadjuvant chemotherapy combined with laparoscopic D2 radical operation in patients with locally advanced gastric cancer.

Methods A total of 86 patients with locally advanced gastric cancer were retrospectively analyzed in the Department of General Surgery, Suzhou Xiangcheng People's Hospital from January 2015 to December 2017, including 43 cases of FLOT neoadjuvant chemotherapy+laparoscopic D2 operation (combined treatment group) and 43 cases of laparoscopic D2 operation (simple operation group). The general clinical data, efficacy, adverse reactions, and survival of the two groups were compared.

Results There were no significant differences in general clinical data between the two groups. The removal rate of R₀ in the combined treatment group was higher than that in the simple operation group (χ²=5.108, P=0.024). The number of patients in T₁+T₂ and N₀+N₁ stages after operation in the combined treatment group was greater than that in the simple operation group (χ²=5.677, P=0.017; χ²=10.488, P=0.001). There was no significant difference in the incidence of adverse reactions between the two groups. The median follow-up time of 86 patients was 54 months. The median OS was 51 months in the combined treatment group and 33 months in the simple operation group. Kaplan-Meier survival analysis suggests that the combined treatment group has significant survival advantage.

Conclusion FLOT neoadjuvant chemotherapy combined with laparoscopic D2 radical operation can improve R₀ resection rate, reduce tumor stage, and improve the prognosis of patients, which has clinical application and promotion value.