化疗联合免疫治疗后行转化手术可改善无腹膜转移Ⅳ期胃癌患者的生存结局——双中心回顾性研究OA

Objective To investigate whether conversion surgery(CS)can enhance clinical outcomes for patients with stage Ⅳ gastric cancer without peritoneal metastasis following immunochemotherapy.Method We retrospectively analyzed data from patients with stage Ⅳ gastric cancer who were initially treated with immunochemotherapy at the First Affiliated Hospital of Nanjing Medical University and the First Clinical Medical College of Southern Medical University from November 1,2019 to April 23,2024.Patients were classified into CS group and non-conversion surgery(NCS)group.A 1 vs.2 propensity score matching(PSM)was performed to balance baseline characteristics.The event-free survival(EFS)and overall survival(OS)were compared between the two groups,and multivariable Cox regression analyses were performed to identify independent prognostic factors associated with EFS and OS.Result Among 230 enrolled patients(CS group:68 cases;NCS group:162 cases)and 133 patients after matching(CS group:43 cases;NCS group:90 cases),median event-free survival(mEFS)and median overall survival(mOS)were not reached in the CS group,whereas the NCS group showed mEFS of 9.34 months(95%CI:8.75-10.79)and 10.79 months(95%CI:9.04-15.02)and mOS of 19.67 months(95%CI:17.06-23.14)and 20.43 months(95%CI:18.15-35.25),respectively.Survival analyses consistently favored the CS group,and multivariate Cox analysis confirmed CS as an independent predictor of improved survival.Conclusion This study found that radical CS following response to first-line immunochemotherapy may significantly improve clinical outcomes and survival in this patient population,further prospective randomized study is warranted.