Analysis of short-term efficacy and safety of neoadjuvant immunotherapy combined with chemotherapy for locally advanced esophageal squamous
Objective To evaluate the efficacy and safety of immunotherapy combined with chemotherapy in neoadjuvant treatment of locally advanced esophageal squamous cell carcinoma.Methods A retrospective analysis was performed on 90 patients with locally advanced esophageal squamous cell carcinoma who received immunotherapy combined with chemotherapy or chemotherapy alone followed by minimally invasive McKeown surgery in the First Affiliated Hospital of Xinxiang Medical U-niversity from June 2021 to March 2023.They were divided into immunotherapy group and non-immunotherapy group accord-ing to whether combined immunotherapy was used.The preoperative basic data,the occurrence of adverse reactions after neoad-juvant therapy,the relevant information of surgery,the pathological remission rate of surgically resected specimens,and postop-erative complications were compared and analyzed between the two groups.Results A total of 55 patients were included in the immunotherapy group,including 30 males and 25 females,with an average age of(65.75±6.10)years.There were 35 pa-tients in the non-immunotherapy group,including 26 males and 9 females,with an average age of(63.14±7.02)years.Gender,age,smoking and drinking history,preoperative nutritional status,cardiopulmonary function,whether hypertension and diabetes were combined,occurrence of adverse reactions to neoadjuvant therapy,operation time,amount of blood loss during operation,intraoperative thoracic catheter ligation,postoperative chylotho-rax or chyloperitoneum,anastomotic fistula and anastomotic stenosis,pulmonary infection,cardiovascular and cerebrovascular disease in the immunotherapy group and the non-immunotherapy group.There were no statistically significant differences in staging of external and lymph node metastasis,perioperative death,length of hospital stay,recurrence/metastasis within 3 months after discharge(P＞0.05).R0 resection rate in immunotherapy group was better than that in non-immunotherapy group,but there was no statistical significance(P＞0.05).There were significant differences in the depth of tumor invasion,postoperative pathological stage and tumor regression grade(CAP)(P＜0.05).Conclusion Minimally invasive McKeown surgery after neoadjuvant immunotherapy combined with chemotherapy in the treatment of locally advanced esophageal squa-mous cell carcinoma can increase the R0 resection rate and promote tumor regression,while not increasing the operative time,intraoperative blood loss and perioperative complications.
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