Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Cancer Med. 2023 Jun;12(11):12221-12233. doi: 10.1002/cam4.5917. Epub 2023 Apr 16.
Few studies have investigated the efficacy of comprehensive therapies, including immunotherapy, for gastric cancer with synchronous liver metastases (GCLM). We retrospectively compared the effect of immunochemotherapy and chemotherapy alone as conversion therapies on the oncological outcomes of patients with GCLM.
The clinicopathological data of 100 patients with GCLM from February 2017 to October 2021 at our institution were retrospectively analyzed. Patients were divided into immunochemotherapy (n = 33) and chemotherapy-alone (n = 67) groups.
Baseline clinicopathological data did not differ significantly between the two groups. The immunochemotherapy group had a higher overall response rate (59.4% vs. 44.0%, p = 0.029) and disease control rate (71.9% vs. 49.2%, p = 0.036) than the chemotherapy group. The immunochemotherapy group showed better tumor regression in the gastric mass, metastatic lymph nodes, and liver lesions than the chemotherapy group. Ten (30.3%) patients in the immunochemotherapy group and 13 (19.4%) patients in the chemotherapy group underwent surgery after conversion therapy. However, the difference was not statistically significant. The overall survival (OS) and progression-free survival (PFS) rates were better in the immunochemotherapy group than in the chemotherapy group. Treatment-related adverse events occurred in 24 (72.7%) and 47 (70.1%) patients in the immunochemotherapy and chemotherapy groups, respectively.
As a conversion therapy for GCLM, immunotherapy yielded better primary and metastatic tumor regression and survival benefits, with no increase in adverse events compared to chemotherapy.
很少有研究调查包括免疫疗法在内的综合疗法对合并肝转移的胃癌(GCLM)的疗效。我们回顾性比较了免疫化疗和单纯化疗作为转化治疗对 GCLM 患者肿瘤学结局的影响。
回顾性分析了 2017 年 2 月至 2021 年 10 月我院 100 例 GCLM 患者的临床病理资料。患者分为免疫化疗组(n=33)和单纯化疗组(n=67)。
两组患者的基线临床病理数据无显著差异。免疫化疗组的总缓解率(59.4% vs. 44.0%,p=0.029)和疾病控制率(71.9% vs. 49.2%,p=0.036)均高于化疗组。免疫化疗组在胃肿块、转移性淋巴结和肝病变方面的肿瘤退缩情况优于化疗组。免疫化疗组 10 例(30.3%)和化疗组 13 例(19.4%)患者在转化治疗后接受了手术,但差异无统计学意义。免疫化疗组的总生存期(OS)和无进展生存期(PFS)均优于化疗组。免疫化疗组和化疗组分别有 24 例(72.7%)和 47 例(70.1%)患者发生与治疗相关的不良事件。
作为 GCLM 的转化治疗,免疫疗法在原发和转移瘤消退以及生存获益方面优于化疗,且与化疗相比,不良反应无增加。