Shi A N, Zhou Y B, Wang G H
Department of Gastrointestinal Surgery,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Wai Ke Za Zhi. 2025 Jul 1;63(7):581-586. doi: 10.3760/cma.j.cn112139-20250310-00121.
To investigate the impact of neoadjuvant immunotherapy on intra-treatment complications, postoperative complications,and short-term efficacy in patients with advanced gastric cancer. This is a retrospective cohort study. Clinical and pathological data were collected from 103 patients with advanced gastric cancer who underwent neoadjuvant therapy and subsequent surgical treatment at the Department of Gastrointestinal Surgery, Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,between January 2021 and December 2024. Among the patients,70 were male and 33 were female;the age was (58±10)years(range: 29 to 79 years). Patients were divided into two groups based on the neoadjuvant treatment regimen: the chemotherapy-alone group (56 patients) and the immunotherapy plus chemotherapy group(47 patients). There was no statistical significance in the differences of age, gender distribution, tumor location and abdominal surgery history between the two groups (all >0.05). Comparisons between the two groups were performed using Welch's -test, test or Fisher's exact probability test,respectively. No statistically significant differences were observed in the incidence of adverse events during neoadjuvant therapy between the two groups (44.7%(21/47) 60.7% (34/56),>0.05). There were also no statistically significant differences in R0 resection rates (97.9%(46/47) 91.1%(51/56)) and hospitalization costs for surgery((91 759±24 572) yuan (96 873±17 367) yuan) between the two groups (both >0.05). Additionally,the overall postoperative complication rates between the two groups were not significantly different (29.8%(14/47) 26.8%(15/56) ,=0.114，>0.05).In terms of short-term efficacy,the proportion of responders(tumor regression grade 0 and 1) was significantly higher in the immunotherapy plus chemotherapy group compared to the chemotherapy-alone group (36.2%(17/47) 14.3%(8/56), =6.658, =0.010). Neoadjuvant immunotherapy combined with chemotherapy does not increase the incidence of adverse events,surgical resection difficulty,or postoperative complications compared to chemotherapy alone. In terms of short-term efficacy,the addition of immunotherapy shows better performance in tumor regression grade compared to chemotherapy alone.
探讨新辅助免疫治疗对晚期胃癌患者治疗期间并发症、术后并发症及短期疗效的影响。这是一项回顾性队列研究。收集了2021年1月至2024年12月期间在华中科技大学同济医学院附属同济医院胃肠外科接受新辅助治疗及后续手术治疗的103例晚期胃癌患者的临床和病理资料。患者中，男性70例，女性33例；年龄为（58±10）岁（范围：29至79岁）。根据新辅助治疗方案将患者分为两组：单纯化疗组（56例患者）和免疫治疗联合化疗组（47例患者）。两组患者在年龄、性别分布、肿瘤位置及腹部手术史方面的差异均无统计学意义（均>0.05）。两组间比较分别采用Welch's检验、检验或Fisher精确概率检验。两组新辅助治疗期间不良事件发生率无统计学差异（44.7%（21/47）对60.7%（34/56），>0.05）。两组的R0切除率（97.9%（46/47）对91.1%（51/56））及手术住院费用（（91 759±24 572）元对（96 873±17 ）元）也均无统计学差异（均>0.05）。此外，两组术后总体并发症发生率无显著差异（29.8%（14/47）对26.8%（15/56），=0.114，>0.05）。在短期疗效方面，免疫治疗联合化疗组的缓解者（肿瘤退缩分级0和1）比例显著高于单纯化疗组（36.2%（17/47）对14.3%（8/56），=6.658，=0.010）。与单纯化疗相比，新辅助免疫治疗联合化疗不会增加不良事件发生率、手术切除难度或术后并发症。在短期疗效方面，与单纯化疗相比，加用免疫治疗在肿瘤退缩分级方面表现更佳。
