دورية أكاديمية
The safety and efficacy of neoadjuvant immunochemotherapy following laparoscopic gastrectomy for gastric cancer: a multicentre real-world clinical study.
العنوان: | The safety and efficacy of neoadjuvant immunochemotherapy following laparoscopic gastrectomy for gastric cancer: a multicentre real-world clinical study. |
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المؤلفون: | Sun YQ; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Zhong Q; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Lv CB; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China., Zhu JY; Department of General Surgery, The First Affiliated Hospital of Ningbo University, Zhejiang, China., Lin GT; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Zhang ZQ; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Wu D; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Weng CM; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Chen QX; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China., Lian MQ; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China., Zeng WM; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China., Zhang YB; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China., Chen QY; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Lin JX; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Xie JW; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Li P; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Zheng CH; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Lu J; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China., Cai LS; Department of Gastrointestinal Surgery, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China., Huang CM; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China. |
المصدر: | International journal of surgery (London, England) [Int J Surg] 2024 Aug 01; Vol. 110 (8), pp. 4830-4838. Date of Electronic Publication: 2024 Aug 01. |
نوع المنشور: | Journal Article; Multicenter Study |
اللغة: | English |
بيانات الدورية: | Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc. Original Publication: London : Surgical Associates Ltd., c2004- |
مواضيع طبية MeSH: | Stomach Neoplasms*/therapy , Stomach Neoplasms*/drug therapy , Stomach Neoplasms*/surgery , Neoadjuvant Therapy*/adverse effects , Gastrectomy*/adverse effects , Laparoscopy*/adverse effects, Humans ; Male ; Female ; Middle Aged ; Aged ; Treatment Outcome ; China ; Retrospective Studies ; Immunotherapy/methods ; Immunotherapy/adverse effects ; Propensity Score ; Adult |
مستخلص: | Background: The safety and efficacy of neoadjuvant immunochemotherapy (nICT) for locally advanced gastric cancer (LAGC) remain controversial. Methods: Patients with LAGC who received either nICT or neoadjuvant chemotherapy (nCT) at 3 tertiary referral teaching hospitals in China between January 2016 and October 2022 were analyzed. After propensity-score matching (PSM), comparing the radiological response, pathological response rate, perioperative outcomes, and early recurrence between the two groups. Results: After PSM, 585 patients were included, with 195 and 390 patients comprising the nICT and nCT groups, respectively. The nICT group exhibited a higher objective response rate (79.5% vs. 59.0%; P <0.001), pathological complete response rate (14.36% vs. 6.41%; P =0.002) and major pathological response rate (39.49% vs. 26.15%; P =0.001) compared with the nCT group. The incidence of surgical complications (17.44% vs. 16.15%, P =0.694) and the proportion of perioperative textbook outcomes (80.0% vs. 81.0%; P =0.767) were similar in both groups. The nICT group had a significantly lower proportion of early recurrence than the nCT group (29.7% vs. 40.8%; P =0.047). Furthermore, the multivariable logistic analysis revealed that immunotherapy was an independent protective factor against early recurrence [odds ratio 0.62 (95% CI 0.41-0.92); P =0.018]. No significant difference was found in neoadjuvant therapy drug toxicity between the two groups (51.79% vs. 45.38%; P =0.143). Conclusions: Compared with nCT, nICT is safe and effective, which significantly enhanced objective and pathological response rates and reduced the risk for early recurrence among patients with LAGC. Trial Registration: Clinical Trials.gov. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.) |
References: | J Clin Oncol. 2021 Sep 10;39(26):2903-2913. (PMID: 34133211) BMC Cancer. 2022 Dec 13;22(1):1306. (PMID: 36514056) J Natl Compr Canc Netw. 2022 Feb;20(2):167-192. (PMID: 35130500) Br J Surg. 2021 Dec 1;108(12):1417-1425. (PMID: 34694371) Eur J Surg Oncol. 2021 Aug;47(8):2023-2030. (PMID: 33663942) Lancet. 2020 Aug 29;396(10251):635-648. (PMID: 32861308) Lancet. 2019 May 11;393(10184):1948-1957. (PMID: 30982686) JAMA. 2019 May 28;321(20):1983-1992. (PMID: 31135850) Eur J Cancer. 2009 Jan;45(2):228-47. (PMID: 19097774) Cancer. 2003 Oct 1;98(7):1521-30. (PMID: 14508841) Ann Surg. 2022 Jan 1;275(1):140-148. (PMID: 32149825) JAMA Oncol. 2020 Oct 1;6(10):1571-1580. (PMID: 32880601) Future Oncol. 2019 Mar;15(9):943-952. (PMID: 30777447) JAMA Oncol. 2022 Oct 1;8(10):1456-1465. (PMID: 36006624) JAMA Surg. 2022 Jan 1;157(1):9-17. (PMID: 34668963) Ann Oncol. 2022 Nov;33(11):1149-1158. (PMID: 35961599) Surgery. 1992 May;111(5):518-26. (PMID: 1598671) Gastric Cancer. 2021 Nov;24(6):1355-1364. (PMID: 34387763) Gastric Cancer. 2020 May;23(3):391-402. (PMID: 31686260) CA Cancer J Clin. 2021 May;71(3):209-249. (PMID: 33538338) Front Immunol. 2022 Dec 08;13:1078196. (PMID: 36569865) J Clin Oncol. 2011 May 1;29(13):1715-21. (PMID: 21444866) JAMA Surg. 2019 Dec 1;154(12):1093-1101. (PMID: 31553463) J Immunother Cancer. 2022 Mar;10(3):. (PMID: 35296556) Surg Endosc. 2023 Aug;37(8):5902-5915. (PMID: 37072637) Gastric Cancer. 2023 May;26(3):467-477. (PMID: 36808262) CA Cancer J Clin. 2016 Mar-Apr;66(2):115-32. (PMID: 26808342) Gastric Cancer. 2021 Jan;24(1):258-271. (PMID: 32737637) Int J Surg. 2018 Mar;51:120-127. (PMID: 29413875) Ann Surg. 2004 Aug;240(2):205-13. (PMID: 15273542) J Clin Oncol. 2023 Mar 1;41(7):1470-1491. (PMID: 36603169) J Thorac Cardiovasc Surg. 2021 Mar;161(3):836-843.e1. (PMID: 33485662) Int J Surg. 2021 Dec;96:106165. (PMID: 34774726) J Clin Oncol. 2016 Aug 10;34(23):2721-7. (PMID: 27298411) Multivariate Behav Res. 2011 May;46(3):399-424. (PMID: 21818162) JAMA Oncol. 2019 Apr 01;5(4):506-513. (PMID: 30730546) Cancer Commun (Lond). 2021 Aug;41(8):747-795. (PMID: 34197702) Gastric Cancer. 2021 Jan;24(1):214-223. (PMID: 32601909) Lancet. 2021 Jan 30;397(10272):387-397. (PMID: 33485461) N Engl J Med. 2006 Jul 6;355(1):11-20. (PMID: 16822992) JAMA Oncol. 2017 Sep 01;3(9):1237-1244. (PMID: 28448662) Lancet Oncol. 2021 Aug;22(8):1081-1092. (PMID: 34252374) World J Gastroenterol. 2015 May 21;21(19):5934-40. (PMID: 26019458) Lancet Oncol. 2022 Feb;23(2):234-247. (PMID: 35030335) N Engl J Med. 2022 May 26;386(21):1973-1985. (PMID: 35403841) CA Cancer J Clin. 2021 May;71(3):264-279. (PMID: 33592120) Future Oncol. 2022 Jun;18(20):2465-2473. (PMID: 35535555) JAMA Netw Open. 2022 Nov 1;5(11):e2239778. (PMID: 36322089) Future Oncol. 2021 Aug;17(22):2847-2855. (PMID: 33975465) Lancet. 2021 Jul 3;398(10294):27-40. (PMID: 34102137) |
تواريخ الأحداث: | Date Created: 20240423 Date Completed: 20240815 Latest Revision: 20240817 |
رمز التحديث: | 20240817 |
مُعرف محوري في PubMed: | PMC11326023 |
DOI: | 10.1097/JS9.0000000000001468 |
PMID: | 38652275 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1743-9159 |
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DOI: | 10.1097/JS9.0000000000001468 |