Safety and feasibility of minimally invasive gastrectomy after neoadjuvant immunotherapy for locally advanced gastric cancer:a propensity score-matched analysis in China
Hao Cui1
Wenquan Liang2
Jianxin Cui2
Liqiang Song1
Zhen Yuan1
Lin Chen3
Bo Wei1
1.School of Medicine,Nankai University,Tianjin,P.R.China;Department of General Surgery,The First Medical Center,Chinese PLA General Hospital,Beijing,P.R.China2.Department of General Surgery,The First Medical Center,Chinese PLA General Hospital,Beijing,P.R.China3.School of Medicine,Nankai University,Tianjin,P.R.China
摘要：Background:The effect of neoadjuvant immunotherapy on minimally invasive gastrectomy(MIG)for locally advanced gastric cancer(LAGC)remains controversial.This study aimed to compare short-term outcomes between MIG after neoadjuvant chemo-immunotherapy(NICT-MIG)and MIG after neoadjuvant chemotherapy alone(NCT-MIG),and determine risk factors for post-operative complications(POCs).
Methods:This retrospective study included clinicopathologic data from 193 patients who underwent NCT-MIG or NICT-MIG between January 2020 and February 2023 in the Department of General Surgery,Chinese People’s Liberation Army General Hospital First Medical Center(Beijing,China).Propensity score-matched analysis at a ratio of 1:2 was performed to reduce bias from confounding patient-related variables and short-term outcomes were compared between the two groups.
Results:The baseline characteristics were comparable between 49 patients in the NICT-MIG group and 86 patients in the NCT-MIG group after propensity score matching.Objective and pathologic complete response rates were significantly higher in the NICT-MIG group than in the NCT-MIG group(P<0.05).The overall incidence of treat-related adverse events,intraoperative bleeding,operation time,number of retrieved lymph nodes,time to the first flatus,post-operative duration of hospitalization,overall morbidity,and se-vere morbidity were comparable between the NCT-MIG and NICT-MIG groups(P>0.05).By multivariate logistic analysis,estimated blood loss of>200 mL(P¼0.010)and prognostic nutritional index(PNI)score of<45(P¼0.003)were independent risk factors for POCs after MIG following neoadjuvant therapy.
Conclusions:Safety and feasibility of NICT were comparable to those of NCT in patients undergoing MIG for LAGC.Patients with an estimated blood loss of>200 mL or a PNI score of<45 should be carefully evaluated for increased POCs risk.
机标关键词：immunotherapyadvancedanalysiscancersafetyafterchinafeasibility
论文发表日期：2024-10-30
在线出版日期：2026-07-17（本平台首次上网日期，不代表文献的发表时间）
页数：10( 437-446 )
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