Perioperative efficacies of neoadjuvant chemotherapy for advanced gastric cancer and gastroesophageal junction adenocarcinoma
Objective To explore the effect of neoadjuvant chemotherapy or immunochemotherapy on perioperative safety and efficacy in patients with advanced gastric cancer(GC)and adenocarcinoma of gastroesophageal junction.Methods From January 2021 to January 2024,retrospective review was performed for the relevant clinical data of 88 patients undergoing neoadjuvant therapy and surgery.Individuals on preoperative radiotherapy were excluded.Based upon different preoperative medication regimens,they were assigned into two groups of neoadjuvant chemotherapy alone(n=55)and preoperative immunochemotherapy(n=33).No statistically significant inter-group differences existed in clinicopathological characteristics.The major outcome measures included operative duration,volume of blood loss,R0 resection rate,dissected lymph node number,time to an initial anal exhaust,length of postoperative hospitalization stay,total hospitalization expense and the incidence of postoperative overall and severe complications.Secondary outcome measure was tumor regression grade(TRG)of primary gastric lesion.Results No statistically significant inter-group differences existed in operative duration,volume of blood loss,R0 resection rate,number of lymph node dissections,time to an initial anal exhaust,total hospitalization expense or length of postoperative stay.The overall incidence of postoperative complications was slightly higher in combination immunotherapy group.There was no statistically significant difference(P>0.05).Both groups exhibited remarkably low rates of severe complications.There was no statistically significant difference(P>0.05).As compared with neoadjuvant chemotherapy alone group,preoperative immunochemotherapy group had a significantly higher proportion of complete/partial remission(P<0.05).And the proportion of TRG grade 0/1 was significantly higher in preoperative immunochemotherapy group(P<0.05).Conclusion Preoperative immunochemotherapy does not elevate perioperative surgical risks and may achieve better short-term outcomes.Further studies are required for evaluating possible long-term outcomes.
NETL
NSTL
万方数据
