ArticleLangenbeck's archives of surgery2026
Neoadjuvant chemoradiotherapy versus neoadjuvant chemoimmunotherapy for esophageal squamous cell carcinoma with three-field lymph node dissection.
Article in Langenbeck's archives of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPresently, there is a paucity of data supporting the efficacy of three-field lymph node dissection following neoadjuvant treatment. This study was designed to investigate the therapeutic efficacy and safety of neoadjuvant chemoimmunotherapy compared with the conventional neoadjuvant chemoradiotherapy regimen, both in conjunction with three-field lymph node dissection.
methodsPatients who underwent esophageal cancer surgery from June 2018 to June 2022 were evaluated. The primary endpoints focused on surgery-related complications and the degree of tumor regression. Additionally, the secondary endpoints included 2-year overall survival (OS) rates and recurrence-free survival (RFS) rates.
resultsFifty-seven patients were recruited, with 30 assigned to the neoadjuvant chemoradiotherapy (NCRT) group and 27 to the neoadjuvant chemoimmunotherapy (NICT) group. The NCRT group had a higher complication rate than the NICT group did (53.3% versus 44.4%, p = 0.503). Notably, the incidence of complications rated above Clavien–Dindo grade III was greater in the NCRT group (13.3% versus 7.4%, p = 0.433). The NCRT group had a higher pathological complete response (pCR) rate (33.3% versus 18.5%, p = 0.205), and a major pathological response (MPR) rate (53.3% versus 29.6%, p = 0.070). However, there was no significant difference in the 2-year overall survival (OS) rate (86.7% versus 74.1%, HR = 2.026; 95%CI,0.593-6.923; p = 0.250) or the 2-year recurrence-free survival (RFS) rate (76.7% versus 63.0%, HR = 1.807; 95%CI,0.688-4.749; p = 0.220) between the NCRT and NICT groups.
conclusionsNeoadjuvant chemoradiotherapy is associated with more postoperative complications, whereas the two treatment approaches yielded comparable prognoses. Three-field lymph node dissection after neoadjuvant therapy is proven safe and feasible in this study.
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