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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1463936
This article is part of the Research Topic The Role of Adjuvant and Neoadjuvant Therapy in Resectable Esophageal Cancer View all articles

Higher 3-Year Recurrence-Free Survival Rate in Patients with Complete Pathological Remission Following Neoadjuvant Chemotherapy Plus Immunotherapy for Esophageal Cancer: A Two-Center, Propensity Score Matching Study

Provisionally accepted
Hai Zhang Hai Zhang 1,2*quan Hai He quan Hai He 2yi Qing Feng yi Qing Feng 2meng Bo Wu meng Bo Wu 2Ying Chen Ying Chen 2yang Zhen Zhang yang Zhen Zhang 3rong Lin Zhou rong Lin Zhou 2Cui Li Cui Li 2li Wan Lin li Wan Lin 2bo Jiang Lin bo Jiang Lin 1,3*
  • 1 Graduate School, Fujian Medical University, Fuzhou, China
  • 2 The People’s Hospital of Gaozhou, Gaozhou, China
  • 3 Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China

The final, formatted version of the article will be published soon.

    Background: Neoadjuvant therapy is preferentially recommended for resectable locally advanced esophageal malignancies, with patients who achieve pathological complete response (PCR) anticipated to have longer survival rates. The aim of this study was to compare 3-year follow-up data for patients with esophageal malignancy who achieved PCR through neoadjuvant chemotherapy (nCRT) and to compare the findings with those of neoadjuvant immunotherapy plus chemotherapy (nICT). Methods: This retrospective study included 85 patients with esophageal cancer who underwent surgical resection following nCRT (n=47) or nICT (n=38) between January 1, 2016 and January 1, 2020 at Fujian Medical University Union Hospital and Gaozhou People's Hospital. Propensity score matching was used to match baseline data and reduce bias between the patient groups. Data during the neoadjuvant treatment and perioperative periods were compared, and follow-up was performed to evaluate differences in 3-year survival rate and recurrence-free survival. Results: After propensity score matching, 28 nCRT patients and 38 nICT patients were included. During neoadjuvant therapy, the nCRT group had higher incidences of leukopenia and neutropenia than did the nICT group. No significant differences were observed in the incidences of hemoglobin decrease, platelet decrease, liver function damage, elevated serum creatinine, diarrhea, radioactive pneumonia or immunotherapy-related pneumonia, and esophageal perforation. The nCRT group had fewer lymph node dissections and lymph node stations. Postoperative lung infection (50.00%) was significantly higher in the nICT group than in the nCRT group (25.00%). The 3-year survival rates were 97.37% and 85.71% in the nICT and nCRT groups, respectively; the 3-year recurrence-free survival rate was significantly lower in the nCRT group (82.14%) than in the nICT group (97.37%, P=0.02). Conclusions: These findings suggest that patients with esophageal cancer who achieve PCR after nICT treatment may have lower rates of disease recurrence.

    Keywords: esophageal squamous cell carcinoma, Immunotherapy, Neoadjuvant chemoradiotherapy, Pathological complete response, Recurrence-free survival

    Received: 12 Jul 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Zhang, He, Feng, Wu, Chen, Zhang, Zhou, Li, Lin and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Hai Zhang, Graduate School, Fujian Medical University, Fuzhou, China
    bo Jiang Lin, Graduate School, Fujian Medical University, Fuzhou, China

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