Association of Neoadjuvant Immunotherapy With Postoperative Major Morbidity After Oncologic Surgery.
Anal cancer
Colon cancer
Esophageal cancer
Immunotherapy
Neoadjuvant
Non-small cell lung cancer
Oral cancer
Postoperative complications
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
28 Sep 2024
28 Sep 2024
Historique:
received:
26
08
2024
accepted:
17
09
2024
medline:
29
9
2024
pubmed:
29
9
2024
entrez:
28
9
2024
Statut:
aheadofprint
Résumé
Despite increasing use of immunotherapy in the treatment of various cancer types, understanding of its impact on postoperative complications still is limited. This study aimed to characterize the association between neoadjuvant immunotherapy and surgical outcomes for rectal, colon, anal, esophageal, lung (non-small cell), and oral cavity cancers. Using the National Cancer Database (NCDB), the study selected patients ages 18-90 years who underwent non-palliative oncologic surgery between 2010 and 2020. The primary outcome was major morbidity, defined as hospital length of stay within the top decile of each surgery subtype, unplanned 30-day readmission, or 30-day mortality. Multivariable logistic regressions for major morbidity were performed to assess neoadjuvant immunotherapy effects by cancer type while controlling for patient demographics, Charlson-Deyo comorbidity index, cancer staging, procedure type, surgical approach, and other treatment (e.g., chemotherapy or radiotherapy). Of 1,348,334 cases with any of the six cancer types, the study sample included 953,612 cases. Of these cases, 4771 (0.5 %) involved neoadjuvant immunotherapy, and 948,841 (99.5 %) did not. The pooled odds ratio was 0.98 (95% confidence interval [CI] 0.81-1.19). Neoadjuvant immunotherapy was not significantly associated with major morbidity after surgery for rectal (adjusted odds ratio [aOR], 0.83; 95% CI 0.60-1.16), colon (aOR, 1.27; 95% CI 0.87-1.85), anal (aOR, 1.90; 95 % CI 0.16-23.15), esophageal (aOR, 0.35; 95% CI 0.08-1.49), lung (non-small cell) (aOR, 1.06; 95% CI 0.65-1.73), or oral (aOR, 1.10; 95% CI 0.61-2.00) cancer. Neoadjuvant immunotherapy is not significantly associated with postoperative complications across several cancer types. As the largest study on neoadjuvant immunotherapy postoperative complications, this study suggests that surgery in the setting of neoadjuvant immunotherapy is safe.
Sections du résumé
BACKGROUND
BACKGROUND
Despite increasing use of immunotherapy in the treatment of various cancer types, understanding of its impact on postoperative complications still is limited. This study aimed to characterize the association between neoadjuvant immunotherapy and surgical outcomes for rectal, colon, anal, esophageal, lung (non-small cell), and oral cavity cancers.
METHODS
METHODS
Using the National Cancer Database (NCDB), the study selected patients ages 18-90 years who underwent non-palliative oncologic surgery between 2010 and 2020. The primary outcome was major morbidity, defined as hospital length of stay within the top decile of each surgery subtype, unplanned 30-day readmission, or 30-day mortality. Multivariable logistic regressions for major morbidity were performed to assess neoadjuvant immunotherapy effects by cancer type while controlling for patient demographics, Charlson-Deyo comorbidity index, cancer staging, procedure type, surgical approach, and other treatment (e.g., chemotherapy or radiotherapy).
RESULTS
RESULTS
Of 1,348,334 cases with any of the six cancer types, the study sample included 953,612 cases. Of these cases, 4771 (0.5 %) involved neoadjuvant immunotherapy, and 948,841 (99.5 %) did not. The pooled odds ratio was 0.98 (95% confidence interval [CI] 0.81-1.19). Neoadjuvant immunotherapy was not significantly associated with major morbidity after surgery for rectal (adjusted odds ratio [aOR], 0.83; 95% CI 0.60-1.16), colon (aOR, 1.27; 95% CI 0.87-1.85), anal (aOR, 1.90; 95 % CI 0.16-23.15), esophageal (aOR, 0.35; 95% CI 0.08-1.49), lung (non-small cell) (aOR, 1.06; 95% CI 0.65-1.73), or oral (aOR, 1.10; 95% CI 0.61-2.00) cancer.
CONCLUSIONS
CONCLUSIONS
Neoadjuvant immunotherapy is not significantly associated with postoperative complications across several cancer types. As the largest study on neoadjuvant immunotherapy postoperative complications, this study suggests that surgery in the setting of neoadjuvant immunotherapy is safe.
Identifiants
pubmed: 39341918
doi: 10.1245/s10434-024-16284-8
pii: 10.1245/s10434-024-16284-8
doi:
Types de publication
Letter
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. Society of Surgical Oncology.
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