Conversion Surgery Following Combination Treatment With Immune Checkpoint Inhibitors and Chemotherapy for Initially...

Area of Science:

• Surgical Oncology
• Gastroenterology
• Medical Oncology

Background:

• Advanced gastric cancer (GC) treatment has evolved with new drug therapies.
• Conversion surgery (CS) is increasingly used for initially unresectable GC.
• Limited data exists on CS following immune checkpoint inhibitor (ICI) and chemotherapy combinations.

Purpose of the Study:

• To evaluate the outcomes of conversion surgery (CS) in patients with initially unresectable advanced gastric cancer (GC).
• To assess the safety and efficacy of CS after combination therapy with ICIs and chemotherapy.

Main Methods:

• Retrospective cohort study of 36 patients with initially unresectable metastatic GC.
• Thirty-four patients received combination therapy (ICIs + chemotherapy); 11 underwent CS.
• Surgical outcomes (operative time, blood loss, lymph nodes) and oncologic results (R0 resection, survival) were evaluated.

Main Results:

• All 11 patients who underwent CS achieved R0 resection.
• Postoperative pathology showed complete response in 3 patients, ypStage I in 4, II in 3, and III in 1.
• The overall 2-year survival rate for patients who underwent CS was 90.0%.

Conclusions:

• Conversion surgery following combination therapy with ICIs and chemotherapy appears to be a promising option for selected patients with initially unresectable metastatic GC.
• This approach can achieve high rates of complete resection and favorable long-term survival.