The efficacy and feasibility of neoadjuvant immunotherapy plus chemotherapy followed by McKeown minimally invasive oesophagectomy for locally advanced oesophageal squamous cell carcinoma.

IF 1 4区 医学 Q3 SURGERY
Journal of Minimal Access Surgery Pub Date : 2024-07-01 Epub Date: 2023-09-14 DOI:10.4103/jmas.jmas_65_23
Rao-Jun Luo, Zhi-Jun Li, Zheng-Fu He, Pei-Jian Yan, Yun-Zheng Wang, Shao-Hua Xu, Zi-Yi Zhu
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引用次数: 0

Abstract

Introduction: In immunotherapy, antibodies are activated to block immune checkpoints, resist tumour immunosuppression, shrink tumours and prevent a recurrence. As the science behind tumour immunotherapy continuously develops and improves, neoadjuvant immunotherapy bears more prominent advantages: antigen exposure not only enhances the degree of tumour-specific T-cell response but also prolongs the duration of actions. In this study, we evaluated the efficacy and safety of McKeown minimally invasive oesophagectomy (McKeown MIO) following neoadjuvant immunotherapy combined with chemotherapy (NICT) in patients with locally advanced oesophageal cancer (OC).

Patients and methods: In this retrospective study, 94 patients underwent either NICT or neoadjuvant chemotherapy (NCT) followed by MIO at our institution from January 2020 to October 2022. We assessed the therapy-related adverse events and perioperative outcomes and compared them between the two groups.

Results: After completing at least two cycles of neoadjuvant therapy, all patients underwent McKeown MIO with negative margins within 4-7 weeks. Demographic data of the two cohorts were similar. Regarding perioperative characteristics, the median intraoperative blood loss was 50 ml in the NICT group, lower than that of the NCT group (100 ml, P < 0.05). In addition, the NICT group had significantly more harvested lymph nodes than the NCT group ( P < 0.05). No significant differences were found in post-operative complications. The rate of objective response rate in the NICT group was higher than that in the NCT group (88.3% vs. 58.8%). Regarding tumour regression, the number of patients with TRG Grades 1-3 in the NICT group was more than that in the NCT. Adverse events experienced by the two groups included anaemia and elevated transaminase. We found no difference in the adverse events between the two groups.

Conclusions: This study showed the efficacy and feasibility of NICT followed by McKeown MIO in treating locally advanced OC.

新辅助免疫治疗加化疗联合麦基翁微创食管切除术治疗局部晚期食管鳞状细胞癌的疗效和可行性。
简介:在免疫疗法中,抗体被激活以阻断免疫检查点,抵抗肿瘤免疫抑制,缩小肿瘤并防止复发。随着肿瘤免疫疗法背后的科学不断发展和完善,新辅助免疫疗法具有更突出的优势:抗原暴露不仅增强了肿瘤特异性T细胞反应的程度,而且延长了作用的持续时间。在这项研究中,我们评估了局部晚期癌症(OC)患者在新辅助免疫疗法联合化疗(NICT)后进行McKeown微创食管切除术(McKeown MIO)的有效性和安全性。患者和方法:在这项回顾性研究中,2020年1月至2022年10月,94名患者在我院接受了NICT或新辅助化疗(NCT),随后接受了MIO。我们评估了与治疗相关的不良事件和围手术期结果,并对两组进行了比较。结果:在完成至少两个周期的新辅助治疗后,所有患者都在4-7周内接受了阴性边缘的McKeown MIO。两组人群的人口学数据相似。就围手术期特征而言,NICT组的中位术中出血量为50ml,低于NCT组(100ml,P<0.05)。此外,NICT小组的淋巴结收获量明显多于NCT小组(P<0.05)。术后并发症没有显著差异。NICT组的客观有效率高于NCT组(88.3%对58.8%)。关于肿瘤消退,NICT组TRG 1-3级患者的数量多于NCT。两组患者出现的不良事件包括贫血和转氨酶升高。我们发现两组之间的不良事件没有差异。结论:本研究显示了NICT联合麦基翁MIO治疗局部晚期OC的疗效和可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
0.00%
发文量
151
审稿时长
36 weeks
期刊介绍: Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.
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