Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2024; 16(3): 700-709
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.700
Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis
Kai Liu, Chun-Xiao Wu, Hui Liang, Tao Wang, Ji-Yuan Zhang, Xiao-Tao Wang
Kai Liu, Hui Liang, Department of Radiation and Oncology, Traditional Chinese Hospital of Lu’an affiliated to Anhui University of Traditional Chinese Medicine, Lu’an 237000, Anhui Province, China
Chun-Xiao Wu, Department of Gastroenterology, Ehu branch of Xishan People’s Hospital of Wuxi City, Wuxi 214116, Jiangsu Province, China
Tao Wang, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510400, Guangdong Province, China
Ji-Yuan Zhang, Department of Gastrointestinal Surgery, Hunan Provincial People’s Hospital, Changsha 410002, Hunan Province, China
Xiao-Tao Wang, Department of Traditional Chinese medicine, Ehu branch of Xishan People’s Hospital of Wuxi City, Wuxi 214116, Jiangsu Province, China
Co-first authors: Kai Liu and Chun-Xiao Wu.
Author contributions: Liu K and Wu CX wrote the manuscript and contributed to the study equally; Liang H, Wang T, and Zhang JY collected the data; Wang XT guided the study; all authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Institutional review board statement: This study has been reviewed and approved by the Clinical Medical Ethics Committee (Approval No. 2021HN26A).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at wxtxyjc@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Tao Wang, Doctor, Department of Traditional Chinese medicine, Ehu Branch of Xishan People’s Hospital of Wuxi City, No. 1 Xuehai East Road, Xishan District, Wuxi 214116, Jiangsu Province, China. wxtxyjc@163.com
Received: January 2, 2024
Peer-review started: January 2, 2024
First decision: January 16, 2024
Revised: January 17, 2024
Accepted: February 20, 2024
Article in press: February 20, 2024
Published online: March 27, 2024
ARTICLE HIGHLIGHTS
Research background

Gastric cancer (GC) is the fifth most common type of cancer and has the fourth highest death rate among all cancers. There is a lack of studies examining the impact of liver metastases on the effectiveness of immunotherapy in individuals diagnosed with GC.

Research motivation

This study retrospectively examined patients with advanced GC who received immunotherapy in the undergraduate department to investigate the influence of liver metastases.

Research objectives

To investigate the influence of liver metastases on the effectiveness and safety of immunotherapy in patients with advanced GC.

Research methods

This retrospective investigation collected clinical data of patients with advanced stomach cancer who had immunotherapy at our hospital from February 2021 to January 2023. The baseline attributes were compared using either the Chi-square test or the Fisher exact probability method. The chi-square test and Kaplan-Meier survival analysis were employed to assess the therapeutic efficacy and survival duration in GC patients with and without liver metastases.

Research results

The analysis comprised 48 patients diagnosed with advanced GC, who were categorized into two groups: A liver metastasis cohort (n = 20) and a non-liver metastatic cohort (n = 28). Patients with liver metastasis exhibited a more deteriorated physical condition compared to those without liver metastasis. The objective response rates in the cohort with metastasis and the cohort without metastasis were 15.0% and 35.7% (P > 0.05), respectively. Similarly, the disease control rates (DCR) in these two cohorts were 65.0% and 82.1% (P > 0.05), respectively. The median progression-free survival was 5.0 months in one group and 11.2 months in the other group, with a hazard ratio of 0.40 and a significance level (P) less than 0.05. The median overall survival was 12.0 months in one group and 19.0 months in the other group, with a significance level (P) greater than 0.05.

Research conclusions

Immunotherapy is less effective in GC patients with liver metastases compared to those without liver metastasis.

Research perspectives

This study provides valuable insights into the efficacy and safety of immunotherapy in patients with GC and liver metastases. In the future, we will look at more detailed molecular level studies to explore the possibility of personalized therapy. In addition, we plan to strengthen the analysis of the mechanisms of immune response after treatment to reveal potential molecular markers of treatment success or failure. In clinical practice, we will strive to promote the translation of research results to provide patients with more personalized and precise treatment options. This series of future work will further promote the application of immunotherapy in GC and liver metastases, and bring more effective and safe treatment options to patients.