دورية أكاديمية
أعرض في EDS

The safety and efficacy of neoadjuvant immunochemotherapy following laparoscopic gastrectomy for gastric cancer: a multicentre real-world clinical study.

التفاصيل البيبلوغرافية
العنوان: The safety and efficacy of neoadjuvant immunochemotherapy following laparoscopic gastrectomy for gastric cancer: a multicentre real-world clinical study.
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.)
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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
الوصف
تدمد:1743-9159
DOI:10.1097/JS9.0000000000001468