A meta-analysis of cohort studies assessing FLOT regimen in the treatment of esophageal cancer.

379 Background: The perioperative FLOT regimen (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel) has shown superior outcomes in gastric and gastroesophageal junction adenocarcinomas. However, its effectiveness in esophageal cancer remains uncertain, particularly outside randomized settings. This systematic review and meta-analysis of cohort studies evaluates the comparative efficacy and safety of FLOT versus standard regimens in esophageal cancer. Methods: Following PRISMA guidelines, PubMed, and Cochrane Library were searched from inception till May 5, 2025. Retrospective and prospective cohort studies comparing FLOT with other regimens in esophageal cancer were included. Outcomes assessed included R0 resection rate, postoperative mortality, tumor regression grade (TRG), pathologic complete response (pCR), and completion of neoadjuvant therapy. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The random-effects model was used to calculate the weighted pooled risk ratio (RR) with the corresponding 95% confidence intervals (CI) of our desired outcome. I 2 and χ 2 statistics assessed heterogeneity with a p-value of