Comparison of the efficacy between immunochemotherapy and chemotherapy in gastric cancer accompanied with synchronous liver metastases: A real‐world retrospective study

• Published in: Cancer medicine (Malden, MA) MA), 2023-06, Vol.12 (11), p.12221-12233
• Main Authors: Lin, Guang‐Tan, Liu, Zhi‐Yu, Shang‐Guan, Zhi‐Xin, Zeng, Gui‐Rong, Lin, Jian‐Xian, Wu, Ju, Chen, Qi‐Yue, Xie, Jian‐Wei, Li, Ping, Huang, Chang‐Ming, Zheng, Chao‐Hui
• Format: Article
• Language: English
• Subjects: Abdomen; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biopsy; Cancer therapies; Chemotherapy; Disease control; Gastric cancer; Gastrointestinal surgery; Humans; Immunotherapy; Immunotherapy - adverse effects; Liver; Liver cancer; liver metastases; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Lymph nodes; Magnetic resonance imaging; Medical prognosis; Metastases; Metastasis; oncological outcomes; Patients; prognosis; Progression-Free Survival; Retrospective Studies; Statistical analysis; Stomach Neoplasms - drug therapy; Stomach Neoplasms - pathology; Surgeons; Survival; Tomography; Tumors
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.5917

Background Few studies have investigated the efficacy of comprehensive therapies, including immunotherapy, for gastric cancer with synchronous liver metastases (GCLM). We retrospectively compared the effect of immunochemotherapy and chemotherapy alone as conversion therapies on the oncological outcomes of patients with GCLM. Methods The clinicopathological data of 100 patients with GCLM from February 2017 to October 2021 at our institution were retrospectively analyzed. Patients were divided into immunochemotherapy (n = 33) and chemotherapy‐alone (n = 67) groups. Results Baseline clinicopathological data did not differ significantly between the two groups. The immunochemotherapy group had a higher overall response rate (59.4% vs. 44.0%, p = 0.029) and disease control rate (71.9% vs. 49.2%, p = 0.036) than the chemotherapy group. The immunochemotherapy group showed better tumor regression in the gastric mass, metastatic lymph nodes, and liver lesions than the chemotherapy group. Ten (30.3%) patients in the immunochemotherapy group and 13 (19.4%) patients in the chemotherapy group underwent surgery after conversion therapy. However, the difference was not statistically significant. The overall survival (OS) and progression‐free survival (PFS) rates were better in the immunochemotherapy group than in the chemotherapy group. Treatment‐related adverse events occurred in 24 (72.7%) and 47 (70.1%) patients in the immunochemotherapy and chemotherapy groups, respectively. Conclusions As a conversion therapy for GCLM, immunotherapy yielded better primary and metastatic tumor regression and survival benefits, with no increase in adverse events compared to chemotherapy. As a conversion therapy for GCLM, immunotherapy yielded better primary and metastatic tumor regression and survival benefit, with no increase in adverse events than did chemotherapy.