Evidence map›Paper›PMID 40854998›Full record

ArticleSurgical endoscopy2025

The enhanced pathological response from additional immunotherapy improved recurrence-free survival for esophageal squamous cell carcinoma: a multi-center cohort study.

Shuhan Xie, Hui Xu, Jinxin Xu, Zilu Tang, Shijie Huang, Jinbiao Xie, Rongyu Xu, Sunkui Ke, Hai Zhang, Mingqiang Kang

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shuhan Xie *Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Hui Xu *Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
Jinxin Xu *Department of Thoracic Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Zilu TangDepartment of Thoracic Surgery, Quanzhou First Hospital, Quanzhou, China.
Shijie Huang *Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China.
Jinbiao XieDepartment of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China. jinbiaoxie123@163.com.
Rongyu XuDepartment of Thoracic Surgery, Quanzhou First Hospital, Quanzhou, China. xry641127@sina.com.
Sunkui KeDepartment of Thoracic Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China. xmzsksk2021@163.com.
Hai ZhangDepartment of Thoracic Surgery, Gaozhou People's Hospital, Gaozhou, Guangdong, China. h_zhang03@163.com.
Mingqiang KangDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China. 9199115045@fjmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmunotherapy shows promise in enhancing pathological responses in locally advanced esophageal squamous cell carcinoma (LA-ESCC), but its long-term survival benefits remain uncertain. This study aims to evaluate the impact of adding immunotherapy to neoadjuvant chemotherapy (nCT) on survival in ESCC patients.

methodsFrom five medical centers, 273 ESCC patients were studied, receiving either neoadjuvant chemoimmunotherapy (nICT) or nCT. Recurrence-free survival (RFS) was the primary endpoint, with locoregional recurrence-free survival (L-RFS) and distant metastasis-free survival (D-MFS) as secondary endpoints. To address confounding biases, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were utilized. An 18-month landmark analysis and Kaplan-Meier curves assessed survival differences.

resultsThe pathological response was significantly improved in the nICT group compared to the nCT group. Cox analysis confirmed nICT as an independent factor associated with better prognosis (HR = 3.05, 95% CI 1.81-5.14, p < 0.001). Before matching, the nICT group showed superior RFS (p < 0.001), L-RFS (p = 0.002), and D-MFS (p < 0.001). After PSM, nICT showed its advantage in RFS (p < 0.001) and D-MFS (p = 0.003), with a trend toward improved L-RFS (p = 0.075). Similarly, after IPTW, nICT maintained its survival benefit in RFS (p = 0.001), D-MFS (p = 0.015), with an observed trend toward enhanced L-RFS (p = 0.085). Stratified analyses revealed greater survival benefits of nICT in patients with ypStage III/IV (p < 0.001). The 18-month landmark analysis demonstrated that nICT significantly enhanced RFS (p < 0.001), L-RFS (p = 0.048), and D-MFS (p < 0.001) with the first 18 months after surgery.

conclusionnICT substantially improves prognostic outcomes in LA-ESCC patients, especially in terms of D-MFS and the period of the first 18-month post-surgery, suggesting nICT could be a more effective treatment strategy. Besides, more prospective investigations are required to substantiate these findings.

Indexed as

Esophageal NeoplasmsEsophageal Squamous Cell CarcinomaImmunotherapyNeoadjuvant TherapyAgedChemotherapy, AdjuvantCohort StudiesDisease-Free SurvivalFemaleHumansMaleMiddle AgedNeoplasm Recurrence, LocalPropensity ScoreRetrospective StudiesDistant metastasis-free survivalLocoregional recurrence-free survivalNeoadjuvant chemoimmunotherapyNeoadjuvant chemotherapyRecurrence-free survivalTail effect

Identifiers

PMID40854998

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.