Safety and feasibility of minimally invasive gastrectomy after neoadjuvant immunotherapy for locally advanced gastric cancer:a propensity score-matched analysis in China  

作　　者：Hao Cui Wenquan Liang Jianxin Cui Liqiang Song Zhen Yuan Lin Chen Bo Wei 

机构地区：[1]School of Medicine,Nankai University,Tianjin,P.R.China [2]Department of General Surgery,The First Medical Center,Chinese PLA General Hospital,Beijing,P.R.China

出　　处：《Gastroenterology Report》2024年第1期69-78,共10页胃肠病学报道(英文)

基　　金：supported by the National Natural Science Foundation of China[82073192,82273231];the Beijing Science and Technology Program[Z221100007422125];Both of the above-mentioned foundations provided financial support on data collection and statistical analysis.

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 severe morbidity were comparable between the NCT-MIG and NICT-MIG groups(P>0.05).By multivariate logistic analysis,estimated blood loss of>200mL(P=0.010)and prognostic nutritional index(PNI)score of<45(P=0.003)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>200mL or a PNI score of<45 should be carefully evaluated for increased POCs risk.

关 键 词：gastric neoplasm neoadjuvant immunotherapy post-operative complications risk factor 

分 类 号：R735.2[医药卫生—肿瘤]