[The impact of neoadjuvant immunotherapy on postoperative complications and short-term efficacy in patients with advanced gastric cancer].

Objective: To investigate the impact of neoadjuvant immunotherapy on intra-treatment complications, postoperative complications,and short-term efficacy in patients with advanced gastric cancer. Methods: This is a retrospective cohort study. Clinical and pathological data were collected from 103 patients with advanced gastric cancer who underwent neoadjuvant therapy and subsequent surgical treatment at the Department of Gastrointestinal Surgery, Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,between January 2021 and December 2024. Among the patients,70 were male and 33 were female;the age was (58±10)years(range: 29 to 79 years). Patients were divided into two groups based on the neoadjuvant treatment regimen: the chemotherapy-alone group (56 patients) and the immunotherapy plus chemotherapy group(47 patients). There was no statistical significance in the differences of age, gender distribution, tumor location and abdominal surgery history between the two groups (all P>0.05). Comparisons between the two groups were performed using Welch's t-test,χ2 test or Fisher's exact probability test,respectively. Results: No statistically significant differences were observed in the incidence of adverse events during neoadjuvant therapy between the two groups (44.7%(21/47) vs. 60.7% (34/56),P>0.05). There were also no statistically significant differences in R0 resection rates (97.9%(46/47) vs. 91.1%(51/56)) and hospitalization costs for surgery((91 759±24 572) yuan vs. (96 873±17 367) yuan) between the two groups (both P>0.05). Additionally,the overall postoperative complication rates between the two groups were not significantly different (29.8%(14/47) vs. 26.8%(15/56) ,χ2=0.114，P>0.05).In terms of short-term efficacy,the proportion of responders(tumor regression grade 0 and 1) was significantly higher in the immunotherapy plus chemotherapy group compared to the chemotherapy-alone group (36.2%(17/47) vs. 14.3%(8/56), χ2=6.658, P=0.010). Conclusions: Neoadjuvant immunotherapy combined with chemotherapy does not increase the incidence of adverse events,surgical resection difficulty,or postoperative complications compared to chemotherapy alone. In terms of short-term efficacy,the addition of immunotherapy shows better performance in tumor regression grade compared to chemotherapy alone.