ArticleSurgical endoscopy2025
Impact of clinical decisions on patient outcomes after neoadjuvant therapy in locally advanced resectable esophageal squamous cell carcinoma.
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 3 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The safety and efficacy of neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma: a meta-analysis and systematic review.Frontiers in immunology · 2026Pooled it
- Trial
- Angiotensin inhibitors during neoadjuvant chemotherapy improve esophageal squamous cell carcinoma outcomes.Therapeutic advances in medical oncology · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeoadjuvant therapy (NAT) is the standard treatment for locally advanced esophageal cancer. Nevertheless, the response to NAT varies significantly among patients. This study is aimed at comparing the influence of different clinical decisions on disease-free survival (DFS) and overall survival (OS) in patients evaluated as stable disease (SD) or clinical response (CR/PR) after NAT.
methodsThis retrospective, multicenter cohort study included patients with locally advanced and resectable ESCC who underwent NAT from January 2016 to January 2022. After NAT, patients were classified into CR/PR and SD groups. Each group was further divided into surgical and non-surgical subgroups. Kaplan-Meier survival analysis was used to compare OS and DFS between groups, and Cox regression was used to identify independent prognostic factors.
resultsA total of 518 patients were included, with 286 classified as CR/PR and 232 as SD. In the SD group, 170 patients (73.3%) underwent surgery, while 62 (26.7%) refused. In the CR/PR group, 246 patients (86.0%) underwent surgery, and 40 (14.0%) refused. Survival analysis revealed that surgery significantly improved OS and DFS in the SD group, and multivariate analysis identified surgery as an independent prognostic factor for both OS and DFS. In the CR/PR group, surgery significantly improved DFS and was an independent factor for DFS, but it did not significantly impact long-term OS.
conclusionsIn patients with clinically stable disease, surgery significantly improves both DFS and OS. In patients with clinical response, surgery improves DFS but has no significant impact on long-term OS.
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