Evidence map›Paper›PMID 42323452›Full record

Observational studyAnnals of surgical oncology2026

Adjuvant Immunotherapy Improves Esophageal Squamous Cell Carcinoma Survival After Neoadjuvant Chemoimmunotherapy: A Multicenter Real-World Study.

Zhuolun Xie, Zhiping Xiu, Yiping Lin, Ning Gong, Fang Peng, Wencheng Zhang, Rong Wang, Wei Wang

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Annals of surgical oncology, 2026. 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. Article
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4 · The record

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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

8 authors.

Zhuolun Xie *Department of Radiation Oncology, Nanfang hospital, Southern Medical University, Guangzhou, China.
Zhiping Xiu *Department of Radiation Oncology, Nanfang hospital, Southern Medical University, Guangzhou, China.
Yiping Lin *Department of Radiation Oncology, Nanfang hospital, Southern Medical University, Guangzhou, China.
Ning GongDepartment of Radiation Oncology, Nanfang hospital, Southern Medical University, Guangzhou, China.
Fang PengDepartment of Radiation Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China. pengf5@mail.sysu.edu.cn.
Wencheng ZhangDepartment of Radiation Oncology, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China. wczhang@tmu.edu.cn.
Rong WangDepartment of Radiation Oncology, Nanfang hospital, Southern Medical University, Guangzhou, China. 836590644@qq.com.
Wei WangDepartment of Radiation Oncology, Nanfang hospital, Southern Medical University, Guangzhou, China. wwei9500@smu.edu.cn.ORCID http://orcid.org/0000-0001-8887-8499

Funding

the Guangdong Basic and Applied Basic Research Foundation 2023A1515010360the National Natural Science Foundation of China Grant 82102807the National Natural Science Foundation of China Grant 82172642the National Natural Science Foundation of China Grant 82373410the Natural Science Foundation of Guangdong Province 2022A1515220195
6 · The paper itself

Abstract

purposeEvidence for adjuvant immunotherapy after neoadjuvant chemoimmunotherapy (NCIT) remains limited. This study aims to assess survival benefits of adjuvant immunotherapy in esophageal squamous cell carcinoma (ESCC) patients treated with NCIT.

methodsThis multicenter retrospective study analyzed 398 esophageal cancer patients who underwent NCIT followed by R0 resection (2019-2023). Postoperatively, 147 received immunotherapy (ICIs group) and 251 did not (non-ICIs group). After propensity score matching (PSM), 143 patients were included in each group. The primary endpoints were 2-year overall survival (OS) and disease-free (DFS) rates.

resultsBefore matching, adjuvant immunotherapy showed no significant OS (hazard ratio [HR] 0.68, p = 0.14) or DFS (HR = 0.75, p = 0.161) benefit versus non-ICIs in ESCC patients. Post-PSM, however, ICIs demonstrated significantly improved 2-year DFS (HR = 0.57, p = 0.013) and OS (HR = 0.47, p = 0.008). Subgroup analyses revealed that ≤65 years, male, lower location, cT3-4, cN1, ypT3-4, ypN2-3, ypIIIB-IVA stage, non-pCR, and non-MPR were significantly associated with survival benefits from adjuvant immunotherapy. Both before and after matching, pCR patients did not benefit from immunotherapy, whereas non-pCR patients exhibited significantly improved DFS (HR = 0.54, p = 0.007) and OS (HR = 0.48, p = 0.01) after matching. Multivariate Cox analysis showed that adjuvant chemoimmunotherapy was the only regimen independently improving both DFS and OS compared to no adjuvant therapy, while immunotherapy alone did not demonstrate significant survival improvement.

conclusionsAdjuvant immunotherapy enhanced survival in NCIT-treated ESCC patients overall, although no survival benefit was observed with adjuvant immunotherapy in pCR patients. Whereas non-pCR patients may benefit from adjuvant immunotherapy, with chemoimmunotherapy may be the optimal strategy. These findings are exploratory. Further validation in longer follow-up time, larger cohorts or prospective studies are needed.

Indexed as

Esophageal NeoplasmsEsophageal Squamous Cell CarcinomaImmunotherapyNeoadjuvant TherapyAgedAntineoplastic Combined Chemotherapy ProtocolsChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateAdjuvant TherapyImmunotherapyLocally Advanced Resectable Esophageal CancerNeoadjuvant ChemoimmunotherapyRetrospective Study

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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.