Adjuvant therapy after neoadjuvant immunotherapy combined with chemotherapy in locally advanced resectable esophageal squamous cell carcinoma: A retrospective study study.

Abstract

e16152 Background : In esophageal squamous cell carcinoma (ESCC), neoadjuvant immunotherapy combined with chemotherapy followed by surgery (NICT+S) has shown good pathologic complete response rate (pCR) and prognosis. However, it is not known whether patients with ESCC who have received t also require adjuvant therapy. Methods: Data from 293 patients who received NICT+S between 2021 and 2023 were retrospectively analyzed. To compare disease-free survival (DFS) and overall survival (OS), we produced Kaplan-Meier survival curves. To determine the parameters associated with disease-free survival and overall survival, Cox models were developed using hazard ratios (HRs). Results: Among 293 ESCC patients who received NICT+S, 258 cases were ultimately included in the research. The percentage of R0 resection was 99.6%. After NICT, 62 (24.0%) patients achieved pathological complete response. Adjuvant therapy (AT) was given to 193 (74.8%) patients following NICT+S, 145 (56.2%) patients received adjuvant immunotherapy (AIT), 48 (18.6%) patients received adjuvant chemoradiotherapy (ACRT). There was no statistically significant difference between patients with and without AT in terms of 2-year DFS (78.7% vs. 75.7%, P = 0.68) or 2-year OS (94.9% vs. 90.5%, P = 0.28). Similarly in the presence or absence of AIT (2-year DFS: 76.9% vs. 75.7%, P = 0.877; 2-year OS: 94.5% vs. 90.5%, P = 0.337) and ACRT( 2-year DFS: 84.7% vs. 75.7%, P = 0.321; 2-year OS: 95.8% vs. 90.5%, P = 0.256), there was no statistical difference in survival outcomes. Patients with ypT 0-1 (P < 0.001, HR:0.34), ypN- (P < 0.001, HR:3.31), with T downing stage (P = 0.006, HR:2.68), and without underlying disease (P = 0.0362, HR:1.91), achieved better DFS with AT. Conclusions: The presence of AT had no significant survival benefit for patients with NICT+S. Patients with ypT 0-1, ypN-, T downing stage, and no underlying disease may benefit from AT.