Hello, I posted a while ago when my husband got diagnosed with Stage 2/3 stomach cancer. Since then, he has completed 7 our 8 FLOT cycles and done pretty well with it. He will have the last chemo next week. We meet with the docs mid December to get scans to see how the chemo has worked and make a plan for surgery. His cancer is a High Grade with poorly differentiated cells, so therefore an aggressive type. I am worried that the chemo won't work. Also, he got a second opinion at Moffit and they recommend that not only the stomach is removed, but the spleen and part of the pancreas, as well as local lymph nodes due to suspicious info on the original pet scan. I am wondering what to do if original doc does not also recommend this. Original doc also said that more will be known once the stomach and lymph nodes are removed and sent to pathology. If the nodes are positive, then what does that mean? I will ask these questions to the doc as well. Any advice or info on how your surgery/diagnosis has been is greatly appreciated. Thanks so much.
Hi, my mum was in a similar boat I think. She had 7 upfront (meant to be 8) FLOT and originally the tumour was attached to the pancreas for her by CT and PET. The chemo reduced the size and it detached from the pancreas as it got smaller. The spleen also was considering being removed as it was around blood vessels that supply blood to the spleen. This was going to be decided on the day of the surgery. The stomach was removed (not the spleen/ blood vessel or pancreas) initially and during surgery a pathologist wasthere and looked under the microscope. Based on that, the pancreas and spleen were not removed and they did proper processing of the stomach later (more pathology exams probably more careful, as GA sn’t something to mess with) and then they determined it was an R0 dissection. So maybe the original scan isn’t necessarily meaning you need radical dissection of all organs involved. And that’s worh asking the surgeon for sure. I think lymph nodes inform future treatment- in the original phase 2 study for FLOT they say 8-12 cycles up to the discretion of the surgeon/ oncologist. Please let meknow if you have any questions. And take care 
