新辅助免疫治疗联合微创McKeown术治疗局部晚期食管鳞癌近期结果的回顾性队列研究  

Short-term outcomes of neoadjuvant immunotherapy combined with minimally invasive McKeown esophagectomy for locally advanced thoracic esophageal squamous cell carcinoma:A retrospective cohort study

作　　者：吴汉然 柳常青 孙效辉 田界勇 梅新宇 徐美青 解明然 WU Hanran;LIU Changqing;SUN Xiaohui;TIAN Jieyong;MEI Xinyu;XU Meiqing;XIE Mingran(Department of Thoracic Surgery,The First Affiliated Hospital of University of Science and Technology of China,Hefei,230001,P.R.China)

机构地区：[1]中国科学技术大学附属第一医院胸外科,合肥230001

出　　处：《中国胸心血管外科临床杂志》2024年第12期1767-1774,共8页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81973643)。

摘　　要：目的探索新辅助免疫治疗联合微创McKeown术治疗局部晚期食管癌的临床疗效。方法回顾性纳入2022年7月—2023年3月于中国科学技术大学附属第一医院行微创McKeown手术联合新辅助治疗的局部晚期食管鳞状细胞癌(鳞癌)患者。根据术前是否接受免疫治疗,将患者分为新辅助免疫治疗组和非新辅助免疫治疗组。比较两组患者围手术期临床资料和术后3个月随访资料。结果共纳入47例患者,其中男31例、女16例,平均年龄(67.57±7.64)岁。免疫治疗组29例,非免疫治疗组18例。两组基线资料、围手术期并发症、近期并发症、手术时间、术中出血量、术后辅助治疗、3个月内转移/复发、R0切除率、术后病理分期降期、美国病理学会(CAP)肿瘤退缩分级差异均无统计学意义(P>0.05)。结论新辅助免疫治疗联合微创食管癌手术治疗局部晚期胸段食管鳞癌安全可靠,不延长手术时间,不增加术中出血量和围手术期并发症。Objective To investigate the feasibility,safety,and short-term efficacy of minimally invasive McKeown esophagectomy(MIME)in patients with locally advanced thoracic esophageal squamous cell carcinoma(TESCC)after neoadjuvant immunotherapy.Methods The clinical data of the patients with locally advanced TESCC in the First Affiliated Hospital of University of Science and Technology of China from July 2022 to March 2023 were restrospectively analyzed.They were divided into a neoadjuvant immunotherapy(NI)group and a non-neoadjuvant immunotherapy(NNI)group according to different preoperative neoadjuvant therapy.The perioperative clinical data and 3-month follow-up data were compared between the two groups.Results A total of 47 patients were collected,including 31 males and 16 females with a mean age of(67.57±7.64)years.There were 29 patients in the NI group and 18 patients in the NNI group.There were no statistical differences in baseline data,perioperative complications,short-term complications,surgical time,intraoperative bleeding,postoperative adjuvant therapy,metastasis/recurrence within 3 months,R0 resection rate,postoperative pathological staging decline,or College of American Pathologists(CAP)tumor regression grade between the two groups(P>0.05).Conclusion Neoadjuvant immunotherapy combined with minimally invasive McKeown esophagectomy can be safely and effectively performed for patients with locally advanced TESCC without increasing operation time,intraoperative blood loss and perioperative complications.

关 键 词：食管肿瘤 胸腔镜 食管切除术 颈部吻合 新辅助治疗 

分 类 号：R735.1[医药卫生—肿瘤]