新辅助化疗联合免疫治疗后腹腔镜胃癌手术的疗效与安全性分析
Efficacy and safety analysis of laparoscopic gastric cancer surgery after neoadjuvant chemotherapy combined with immunotherapy
姜行至 1侯振宇 2汤小龙 2曲辉2
作者信息
- 1. 山东大学齐鲁医院胃肠外科,山东 济南,250012;山东大学第一临床医学院
- 2. 山东大学齐鲁医院胃肠外科,山东 济南,250012
- 折叠
摘要
目的:探讨新辅助化疗联合免疫治疗后行腹腔镜胃癌手术的临床疗效及安全性.方法:回顾分析 2016 年 3 月至2020 年8 月行新辅助治疗并接受标准腹腔镜胃癌根治术的113 例进展期胃癌患者的临床资料,将患者分为新辅助化疗联合免疫治疗组(联合组,n=37)与新辅助化疗组(新辅助组,n=76).比较两组患者预后情况.结果:两组患者基线资料差异无统计学意义.联合组总生存时间(P=0.002)、无病生存时间(P<0.001)长于新辅助组,肿瘤退缩分级(P<0.001)、T分期(P=0.022)及N分期(P=0.008)低于新辅助组,脉管浸润(P=0.007)、术后复发(P=0.017)、术后转移(P=0.033)少于新辅助组.两组术中输血、术后住院时间、发热时间、排气时间、并发症发生率及中性粒细胞减少、淋巴细胞减少、血小板减少的发生率差异无统计学意义.结论:新辅助化疗联合免疫治疗后行腹腔镜胃癌根治术是安全、可行的,并可有效改善患者预后.
Abstract
Objective:To investigate the clinical efficacy and safety of laparoscopic gastric cancer surgery after neoadjuvant chemotherapy combined with immunotherapy.Methods:Clinical data of 113 patients with advanced gastric cancer who underwent lapa-roscopic gastric cancer surgery after neoadjuvant chemotherapy were retrospectively analyzed.All patients were divided into neoadjuvant chemotherapy combined with immunotherapy group(combined group,n=37)and neoadjuvant chemotherapy(neoadjuvant group,n= 76).And the prognosis and clinical data of the two groups were compared.Results:The baseline characteristics between the two groups were comparable.Compared with neoadjuvant group,the combined group has longer overall survival time(P=0.002)and disease-free survival time(P<0.001).In terms of clinical efficacy,the combined group was significantly lower than the neoadjuvant group in tumor regression grade(P<0.001),T stage(P=0.022)and N stage(P=0.008),and the combined group was less in number of vascular invasion(P=0.007),postoperative recurrence(P=0.017)and postoperative metastasis(P=0.033).No significant difference in the intraoperative blood transfusion,postoperative hospital stay,fever time,exhaust time,complications incidence,and rate of adverse reac-tions(neutropenia,lymphopenia and thrombocytopenia)were found between the two groups.Conclusions:Laparoscopic gastric cancer surgery after neoadjuvant chemotherapy combined with immunotherapy is safe and feasible,and can effectively improve the prognosis of advanced gastric cancer patients.
关键词
胃肿瘤/胃癌根治术/腹腔镜检查/新辅助化疗/免疫治疗Key words
Stomach neoplasms/Radical gastrectomy/Laparoscopy/Neoadjuvant chemotherapy/Immunotherapy引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据