Retrospective Evaluation of Chemo-Induction Protocols in Gastroesophageal Junction Cancers with Emphasis on PD-L۱ as a Predictive Pathologic Biomarker

Introduction: Gastroesophageal junction cancers show variable responses to chemo-induction, highlighting the need for predictive biomarkers. PD-L۱, through its role in tumor–immune interactions, may help identify patients more likely to benefit from preoperative treatment. This study aimed to retrospectively evaluate chemo-induction outcomes in GEJ cancers with emphasis on PD-L۱ as a predictive pathologic biomarker.Material and methods: This retrospective cross-sectional study, approved by the Tabriz University of Medical Sciences Ethics Committee, evaluated ۱۰۰ gastroesophageal junction cancer patients at Shahid Madani Hospital. Using accessible sampling, clinical data and PD-L۱ expression were analyzed. Statistical analyses, including chi-square tests and logistic regression, were performed to identify predictors of pathological response. Results: In ۱۰۰ patients, baseline variables were comparable between the dexmedetomidine and lidocaine groups (all p > ۰.۰۵). Infusion duration, surgery time, anesthesia time, treatment completion, pathological findings, treatment response, and PD-L۱ positivity did not differ significantly between groups. Only total study drug dose differed significantly (۹۲.۶ ± ۱۸.۴ µg vs. ۲۴۸.۳ ± ۴۱.۷ mg, p < ۰.۰۰۱).Conclusion: These findings indicate that dexmedetomidine and lidocaine were associated with broadly similar perioperative, pathological, and immunohistochemical outcomes in this cohort. The absence of significant between-group differences in pathological response and PD-L۱ expression suggests that neither intervention demonstrated clear superiority in influencing tumor-related postoperative characteristics.

کلیدواژه ها:

dexmedetomidine ، Lidocaine ، PD-L۱ ، Pathological response ، comparative study