Abstract：
BACKGROUND: Patients treated with immunotherapy might need surgical procedures in addition to the medical treatment. The main indications are cytoreductive nephrectomy, cystectomy (as part of clinical trials) and metastasis removal in some oligometastatic patients. This study aims to assess the feasibility of surgery for patients treated by immunotherapy and describes the histological modifications found in the pathological analysis.
METHODS: We conducted a retrospective, monocentric study. We included all patients operated for a urologic cancer and previously treated with systemic immunotherapy between February 2018 and June 2022. We compared this population with a control group of patients treated with surgery without having previous immunotherapy. Patients were compared according to the cancer type, age and sex. We compared perioperative complications. We performed an analysis for evaluation of the peri-tumoral inflammatory infiltration.
RESULTS: We included 50 patients in this study. The two groups were comparable in age (63.7 vs. 63.3years old, P=0.95) and sex (4 and 6 women in the first and second group). The peroperatory complication rate was comparable (20% vs. 16%, P=1). The mean bleeding volume was comparable (664 vs. 629mL; P=0.89). The postoperative complication rate (48% vs. 56%; P=0.78) and their grade (Clavien III-IV 8% vs. 24%; P=0.24) were comparable. The anatomopathological analysis described the same rate and intensity of peri-tumoral inflammatory infiltrate (96% vs. 96%; P=1).
CONCLUSIONS: Preoperative immunotherapy does not appear to be associated with increased surgical difficulty and perioperative complications. Blind histological analysis of the surgical specimens did not reveal any specific features related to pre operative immunotherapy.
METHODS: Grade 3 HAS.
METHODS: We conducted a retrospective, monocentric study. We included all patients operated for a urologic cancer and previously treated with systemic immunotherapy between February 2018 and June 2022. We compared this population with a control group of patients treated with surgery without having previous immunotherapy. Patients were compared according to the cancer type, age and sex. We compared perioperative complications. We performed an analysis for evaluation of the peri-tumoral inflammatory infiltration.
RESULTS: We included 50 patients in this study. The two groups were comparable in age (63.7 vs. 63.3years old, P=0.95) and sex (4 and 6 women in the first and second group). The peroperatory complication rate was comparable (20% vs. 16%, P=1). The mean bleeding volume was comparable (664 vs. 629mL; P=0.89). The postoperative complication rate (48% vs. 56%; P=0.78) and their grade (Clavien III-IV 8% vs. 24%; P=0.24) were comparable. The anatomopathological analysis described the same rate and intensity of peri-tumoral inflammatory infiltrate (96% vs. 96%; P=1).
CONCLUSIONS: Preoperative immunotherapy does not appear to be associated with increased surgical difficulty and perioperative complications. Blind histological analysis of the surgical specimens did not reveal any specific features related to pre operative immunotherapy.
METHODS: Grade 3 HAS.
摘要：
背景：接受免疫治疗的患者除了需要药物治疗外，还可能需要外科手术。主要适应症是细胞减灭术，膀胱切除术（作为临床试验的一部分）和一些寡转移患者的转移切除。这项研究旨在评估接受免疫治疗的患者手术的可行性，并描述病理分析中发现的组织学改变。
方法：我们进行了回顾性研究，单中心研究。我们纳入了2018年2月至2022年6月期间接受过全身免疫疗法治疗的所有泌尿系癌症患者。我们将该人群与接受手术治疗而未接受过免疫疗法的对照组进行了比较。根据癌症类型对患者进行比较，年龄和性别我们比较了围手术期并发症。我们进行了评估肿瘤周围炎症浸润的分析。
结果：我们纳入了50例患者。两组在年龄上具有可比性（63.7vs.63.3岁,P=0.95）和性别（第一组和第二组中的4名和6名女性）。围手术期并发症发生率相当(20%vs.16%,P=1)。平均出血量相当（664比629mL；P=0.89）。术后并发症发生率（48%vs.56%；P=0.78）及其等级（ClavienIII-IV8%vs.24%；P=0.24）具有可比性。解剖病理学分析描述了相同的肿瘤周围炎症浸润率和强度(96%vs.96%；P=1）。
结论：术前免疫治疗似乎与手术难度增加和围手术期并发症无关。手术标本的盲目组织学分析未发现与术前免疫疗法相关的任何特定特征。
方法：三级HAS。
方法：我们进行了回顾性研究，单中心研究。我们纳入了2018年2月至2022年6月期间接受过全身免疫疗法治疗的所有泌尿系癌症患者。我们将该人群与接受手术治疗而未接受过免疫疗法的对照组进行了比较。根据癌症类型对患者进行比较，年龄和性别我们比较了围手术期并发症。我们进行了评估肿瘤周围炎症浸润的分析。
结果：我们纳入了50例患者。两组在年龄上具有可比性（63.7vs.63.3岁,P=0.95）和性别（第一组和第二组中的4名和6名女性）。围手术期并发症发生率相当(20%vs.16%,P=1)。平均出血量相当（664比629mL；P=0.89）。术后并发症发生率（48%vs.56%；P=0.78）及其等级（ClavienIII-IV8%vs.24%；P=0.24）具有可比性。解剖病理学分析描述了相同的肿瘤周围炎症浸润率和强度(96%vs.96%；P=1）。
结论：术前免疫治疗似乎与手术难度增加和围手术期并发症无关。手术标本的盲目组织学分析未发现与术前免疫疗法相关的任何特定特征。
方法：三级HAS。
