{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:58:22Z","timestamp":1786978702449,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Conversion surgery (CS) for unresectable advanced gastric cancer (GC; clinical stage IVb) has increased in recent years owing to advances in drug therapy. However, little is known about CS following combination treatment with immune checkpoint inhibitors (ICIs) and chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of patients initially unresectable metastatic GC. We treated 36 patients with initially unresectable metastatic GC. Thirty\u2010four patients received combination treatment with ICIs and chemotherapy, 11 of whom underwent CS. We evaluated their short\u2010term and long\u2010term surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among patients who underwent CS, six were male and five female, and the median (interquartile range) age was 71 (47\u201375) years. All patients started first\u2010line therapy with S\u20101 plus oxaliplatin combined with nivolumab, and two patients underwent surgery after second\u2010line treatment with ramucirumab and nanoparticle albumin\u2010bound paclitaxel. There were four open, two laparoscopic, and five robotic surgeries. The median operative time was 348 (321\u2013354) minutes, blood loss was 16 (10\u201330) mL, and number of retrieved lymph nodes was 38 (27\u201344); there were no cases of conversion to laparotomy. R0 resection was achieved in all patients. And postoperative pathology was complete response; three patients, ypStage I; four patients, II; three patient, III; zero patient IV; one patient. ICI and chemotherapy efficacy was Grade 1 in four patients, Grade 2 in two patients, and Grade 3 in five patients. Overall 2\u2010year survival was 90.0% for those who underwent CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CS following combination treatment with ICI and chemotherapy may be promising for initially unresectable metastatic GC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70372","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T12:44:21Z","timestamp":1776343461000},"page":"1631-1638","source":"Crossref","is-referenced-by-count":1,"title":["Conversion Surgery Following Combination Treatment With Immune Checkpoint Inhibitors and Chemotherapy for Initially Unresectable Gastric Cancer"],"prefix":"10.1002","volume":"50","author":[{"given":"Masaaki","family":"Nishi","sequence":"first","affiliation":[{"name":"Department of Surgery University of Tokushima Graduate School  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuma","family":"Wada","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tokushima Graduate School  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Takasu","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tokushima Graduate School  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Tokunaga","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tokushima Graduate School  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Nakao","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Tokushima Graduate School  Tokushima 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