在接受新辅助免疫化疗和手术的头颈部鳞状细胞癌患者中，高病理肿瘤反应与总体生存率提高相关。

High pathological tumor response associates with enhanced overall survival in HNSCC patients following neoadjuvant immunochemotherapy and surgery.

作者信息

Ning Yudong, Song Yixuan, Li Han, He Yuqin, Liu Shaoyan, Liu Yang

机构信息

Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.17 PanjiayuanNanli, Chaoyang District, Beijing, 100021, P.R. China.

出版信息

World J Surg Oncol. 2025 May 29;23(1):205. doi: 10.1186/s12957-025-03865-4.

DOI:10.1186/s12957-025-03865-4

PMID:40442776

Abstract

OBJECTIVE

This study aimed to evaluate the impact of the postoperative pathological remission status on the prognosis of patients who underwent surgery after neoadjuvant immunochemotherapy in head and neck squamous cell carcinoma (HNSCC).

METHODS

This study retrospectively analyzed patients who participated in a clinical trial at our hospital. These patients received neoadjuvant pembrolizumab combined with platinum and taxane followed by surgery from March 1, 2021, to November 1, 2024. Clinical and pathological characteristics were collected. Cox regression analysis was used to analyze clinical and pathological characteristics by univariate and multivariate analysis, and Kaplan Meier (KM) survival curves were plotted to evaluate the associations of clinical and pathological characteristics with the progression free survival (PFS) and overall survival(OS). Propensity score matching (PSM) was used to level the baseline of clinical characteristics.

RESULTS

The study cohort consisted of a total of 62 patients. the PFS rate of the patients was 85.5%, and the OS rate was 87.1%. The follow-up period of the patients ranged from 4 to 41 months, with an mean follow-up time of 23.7 months. However, high pathological tumor response (PTR) was significantly associated with better OS (97.2% vs 70.8%) and was an independent prognostic factor ( hazard ratio 0.153; 95% Confidence interval 0.018 - 1.307, p = 0.046). Before and after PSM, patients with high PTR had a significantly longer OS than those without high PTR (p = 0.0258,0.0053).

CONCLUSION

Our study showed a strong OS improvement in patients who achieved high PTR after neoadjuvant immunochemotherapy.

摘要

目的

本研究旨在评估术后病理缓解状态对接受新辅助免疫化疗后手术的头颈部鳞状细胞癌（HNSCC）患者预后的影响。

方法

本研究回顾性分析了在我院参加一项临床试验的患者。这些患者于2021年3月1日至2024年11月1日接受了新辅助帕博利珠单抗联合铂类和紫杉烷治疗，随后接受手术。收集临床和病理特征。采用Cox回归分析进行单因素和多因素分析以分析临床和病理特征，并绘制Kaplan-Meier（KM）生存曲线以评估临床和病理特征与无进展生存期（PFS）和总生存期（OS）的相关性。采用倾向评分匹配（PSM）来平衡临床特征的基线。

结果

研究队列共包括62例患者。患者的PFS率为85.5%，OS率为87.1%。患者的随访期为4至41个月，平均随访时间为23.7个月。然而，高病理肿瘤反应（PTR）与更好的OS显著相关（97.2%对70.8%），并且是一个独立的预后因素（风险比0.153；95%置信区间0.018 - 1.307，p = 0.046）。在PSM前后，高PTR患者的OS明显长于非高PTR患者（p = 0.0258，0.0053）。