Perioperative Outcomes of Minimally Invasive Esophagectomy After Neoadjuvant Immunotherapy for Patients With Locally Advanced Esophageal Squamous Cell Carcinoma.
Perioperative Outcomes of Minimally Invasive Esophagectomy After Neoadjuvant Immunotherapy for Patients With Locally Advanced Esophageal Squamous Cell Carcinoma.
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DOI：
10.3389/fimmu.2022.848881
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发表时间：
2022
影响因子：
7.3
通讯作者：
Chen L
中科院分区：
文献类型：
--
作者：
Cheng J;Guo M;Yang Y;Liu Y;Hu W;Shang Q;Li C;Xia L;Wang Y;Wang W;Tian D;Yuan Y;Hu Y;Chen L
免疫疗法已成为先进的实体肿瘤治疗的支柱。与传统的新辅助治疗相比，患者更有可能从新辅助免疫治疗中获益。然而，新辅助免疫疗法治疗局部晚期、可手术切除的食管鳞状细胞癌（ESCC）的安全性和有效性仍然未知。于2020年6月至2021年9月入组了微创食管胃吻合术后接受新辅助治疗的ESCC患者。研究新辅助治疗和手术的特点，以确定新辅助化疗和免疫治疗（NCI）的安全性和有效性。共有149名患者被纳入研究。NCI和新辅助化疗加放疗（NCR）组之间的患者比例为40：109。在病理学特征方面，包括ypN分期、ypTNM分期、分化程度、淋巴管浸润、神经周围浸润、病理完全消退和肿瘤消退评分均无显著性差异，且这些参数与NCI或NCR均无相关性（均p>0.05）。关于手术，NCI组的失血量（49.25 ± 13.47 vs. 57.02 ± 47.26，p<0.001）和手术时间（247.75 ± 28.28 vs. 285.83 ± 52.43，p<0.001）均少于NCR组。此外，NCI组的总体围手术期并发症（p=0.003）和>2级围手术期并发症（p=0.042）发生率低于NCR组。总体而言，本文报告的研究结果表明，与NCR治疗相比，NCI可以为局部晚期ESCC患者带来更好的结局和更少的并发症。作为一种新的治疗选择，NCI的疗效和安全性似乎是可行的和安全的，但仍需要长期生存数据。
Immunotherapy has become a pillar of advanced solid tumors treatment. Patients are more likely to benefit from neoadjuvant immunotherapy compared with traditional neoadjuvant therapy. However, the safety and efficacy of neoadjuvant immunotherapy for the treatment of locally advanced, surgically resectable Esophageal squamous cell carcinoma (ESCC) remain unknown. ESCC patients who received neoadjuvant treatment following minimally invasive esophagogastrostomy were enrolled from June 2020 to September 2021. The characteristics of neoadjuvant treatment and surgery were investigated to determine the safety and efficacy of the neoadjuvant combination of chemotherapy and immunotherapy (NCI). A total of 149 patients were included in the study. Patient ratio was 40:109 between NCI and neoadjuvant chemotherapy plus radiotherapy (NCR) groups. No significant difference was found in terms of pathological characteristics, including ypN stage, ypTNM stage, differentiation, lymphovascular invasion, perineural invasion, pathological complete regression and tumor regression score, and these parameters were not correlated with NCI or NCR (all p>0.05). Regarding to the operation, the NCI group had less blood loss (49.25 ± 13.47 vs. 57.02 ± 47.26, p<0.001), and shorter operation time (247.75 ± 28.28 vs. 285.83 ± 52.43, p<0.001) than the NCR group. Additionally, the NCI group demonstrated a lower rate of overall perioperative complications (p=0.003) and grade >2 perioperative complications (p=0.042) than the NCR group. Overall, the findings reported here indicate NCI could result in better outcome and less complications to locally advanced ESCC patients compared with NCR therapy. As a novel therapeutic option, the efficacy and safety of NCI appears to be feasible and safe, while long-term survival data is still needed.
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影响因子：
16.9
作者：
D'Journo, Xavier Benoit;Boulate, David;Low, Donald E.
通讯作者：
Low, Donald E.
影响因子：
45.3
作者：
Kelsen, David P.;Winter, Katryn A.;Willett, Christopher G.
通讯作者：
Willett, Christopher G.
影响因子：
9
作者：
Pasquali, Sandro;Yim, Guang;Griffiths, Ewen A.
通讯作者：
Griffiths, Ewen A.
影响因子：
20.4
作者：
Goldstraw, Peter;Chansky, Kari;Bolejack, Vanessa
通讯作者：
Bolejack, Vanessa
影响因子：
158.5
作者：
Kelsen, DP;Ginsberg, R;Roth, JA
通讯作者：
Roth, JA