ArticleJournal of gastrointestinal cancer2026
The Impact of Tumor Volume Change Rate During Neoadjuvant Chemoradiotherapy-immunotherapy and of the Timing to Surgery on Prognosis in Patients with Esophageal Squamous Cell Carcinoma: A Multicenter Study.
Article in Journal of gastrointestinal cancer, 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
purposeIn recent years, neoadjuvant chemoradiotherapy-immunotherapy (NICRT) has shown promising results in improving the prognosis of locally advanced esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the prognostic value of dynamic tumor volume changes during NICRT and to explore the association between the timing to surgery (TTS) and patient outcomes.
methodsThis retrospective multicenter study included 51 patients with histologically confirmed esophageal squamous cell carcinoma, who were treated between October 1, 2020, and October 30, 2023. All patients received NICRT, followed by radical esophagectomy. Tumor volumes were measured on pre- and post-treatment CT scans, and the volume change rate was calculated and correlated with survival outcomes. Overall survival (OS) and disease-free survival (DFS) were assessed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression models were used to identify prognostic factors.
resultsA total of 51 patients were enrolled (median age 61 years, 88.2% male), with T3 being the most common stage (80.4%). Multivariate analysis identified both TTS and the tumor volume change rate as independent predictors of DFS (P = 0.025; P = 0.003) and OS (P = 0.005; P = 0.049). In addition, compared with early surgery, delayed surgery (> 6 weeks) was associated with significantly longer DFS (P = 0.002) and OS (P < 0.001).
conclusionTumor volume change rate is an independent prognostic factor in patients with ESCC treated with NICRT. Undergoing curative surgery six weeks after completion of neoadjuvant therapy may be associated with a better prognosis. However, given the limited sample size, this finding warrants further validation in large-scale prospective studies.
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