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Thoracic cancer
Feb, 2025;16 (4): e70021.

Postoperative Adjuvant Therapy Benefits Non-pCR Patients Rather Than pCR Patients for Locally Advanced ESCC: A Multicenter Real-World Study.

Defeng Liu, Ao Liu, Longxiang Guo, Yi Li, Yuanlin Li, Yuxiang Chi, Haiqun Lin, Jinming Yu, Minghuan Li
Author Information
  1. Defeng Liu: Cheeloo College of Medicine, Shandong University, Jinan, China.
  2. Ao Liu: Cheeloo College of Medicine, Shandong University, Jinan, China.
  3. Longxiang Guo: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
  4. Yi Li: Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
  5. Yuanlin Li: Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
  6. Yuxiang Chi: Cheeloo College of Medicine, Shandong University, Jinan, China.
  7. Haiqun Lin: Department of Radiation Oncology, The Second Hospital of Shandong University, Jinan, China.
  8. Jinming Yu: Cheeloo College of Medicine, Shandong University, Jinan, China.
  9. Minghuan Li: Cheeloo College of Medicine, Shandong University, Jinan, China. ORCID
PMID: 39988453 DOI: 10.1111/1759-7714.70021

Abstract

BACKGROUND: There is no unified standard in adjuvant therapy (AT) for patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant therapy and surgery. We evaluated the significance of AT for these patients and explored its influencing factors.
METHODS: ESCC patients who underwent neoadjuvant therapy and surgery from 2019 to 2022 at three centers were divided into AT (n = 227) and non-AT groups (n = 435). Baseline characteristics were balanced using propensity score matching (PSM). Primary endpoints were disease-free survival (DFS) and overall survival (OS), assessed using the Kaplan-Meier method. Subgroup analyses and univariate and multivariate Cox regression analyses were conducted to identify the prognostic factors.
RESULTS: The median follow-up period is 36 (2-72) months. After PSM, the total population had 1-, 2-, and 3-year OS rates of 71.3%, 66.0%, and 64.1%, respectively. There were no statistically significant differences in DFS (HR: 0.79; 95% CI: 0.55-1.14, p = 0.21) or OS (HR: 0.75; 95% CI: 0.49-1.13, p = 0.17) between AT and non-AT groups. Subgroup analysis revealed that non-pCR patients benefited from AT in DFS (p = 0.042) and OS (p = 0.033). Moreover, in non-pCR patients who received AT, BMI ≥ 21.5 kg/m and ypN0 were independent protective factors of DFS. ypN0 was an independent protective factor of OS. In terms of AT regimens, the Kaplan-Meier analysis revealed that adjuvant immunochemotherapy (AICT) provided superior survival benefits than adjuvant radiotherapy and adjuvant chemotherapy.
CONCLUSIONS: Postoperative AT benefited ESCC patients with non-pCR, while AICT may be a relatively better AT regimen in real-world data, which deserves further exploration.

Keywords

adjuvant therapy disease‐free survival esophageal squamous cell carcinoma immunotherapy overall survival

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Grants

  1. 82172677/National Natural Science Foundation of China

MeSH Term

Humans
Female
Male
Middle Aged
Esophageal Neoplasms
Esophageal Squamous Cell Carcinoma
Aged
Prognosis
Chemotherapy, Adjuvant
Retrospective Studies
Survival Rate
Adult
Postoperative Care
Follow-Up Studies
Neoadjuvant Therapy
Journal Article Multicenter Study

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