Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis
ABSTRACT Background Neoadjuvant chemoimmunotherapy (nICT) has emerged as a novel and promising treatment model for esophageal squamous cell carcinoma (ESCC). However, the optimal interval to esophagectomy after nICT remains unclear. This study aimed to explore the impact of a prolonged interval (7–1...
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| Format: | Article |
| Language: | English |
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Wiley
2025-03-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.70019 |
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| author | Hui Xu Zhinuan Hong Ye Lin Sunkui Ke Zhen Chen Shuhan Xie Dinghang Chen Kaiming Peng Peipei Zhang Mingduan Chen Ziyang Han Jihong Lin Shuchen Chen Jinxin Xu Jinbiao Xie Mingqiang Kang |
| author_facet | Hui Xu Zhinuan Hong Ye Lin Sunkui Ke Zhen Chen Shuhan Xie Dinghang Chen Kaiming Peng Peipei Zhang Mingduan Chen Ziyang Han Jihong Lin Shuchen Chen Jinxin Xu Jinbiao Xie Mingqiang Kang |
| author_sort | Hui Xu |
| collection | DOAJ |
| description | ABSTRACT Background Neoadjuvant chemoimmunotherapy (nICT) has emerged as a novel and promising treatment model for esophageal squamous cell carcinoma (ESCC). However, the optimal interval to esophagectomy after nICT remains unclear. This study aimed to explore the impact of a prolonged interval (7–10 weeks) on short‐ and long‐term outcomes compared to the standard interval (4–6 weeks). Methods This was a multicenter retrospective cohort analysis, including three centers. Patients were diagnosed with locally advanced ESCC (cT3‐4a or cN+) and received radical resection after at least one cycle of nICT. The primary outcomes were pathological response, disease‐free survival (DFS), and overall survival (OS). Inverse probability of treatment weighting (IPTW) was utilized to balance the baseline characteristics. Results One hundred and seventy patients were included in the study, with 123 in the standard interval group and 47 in the prolonged interval group. After IPTW, the prolonged interval group exhibited a higher pathological complete response (pCR) than the standard group, but the difference was not statistically significant (29.5% vs. 41.5%, p = 0.306). Additionally, although the 3‐year DFS and OS rates were higher in the prolonged interval group, these differences did not reach statistical significance. There were no statistically significant variances observed in terms of intraoperative blood loss, surgical time, postoperative hospital stays, duration of thoracic drainage tube placement, hospital expenses, or postoperative complications. Conclusions Patients demonstrated tolerance for esophagectomy within 4–6 weeks after nICT. Based on the present findings regarding pCR, DFS, and OS, extending the time to surgery beyond 6 weeks was found to be acceptable. |
| format | Article |
| id | doaj-art-1030aa8fa38d4ac590f2d93f676009b4 |
| institution | DOAJ |
| issn | 1759-7706 1759-7714 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj-art-1030aa8fa38d4ac590f2d93f676009b42025-08-20T02:53:13ZengWileyThoracic Cancer1759-77061759-77142025-03-01165n/an/a10.1111/1759-7714.70019Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort AnalysisHui Xu0Zhinuan Hong1Ye Lin2Sunkui Ke3Zhen Chen4Shuhan Xie5Dinghang Chen6Kaiming Peng7Peipei Zhang8Mingduan Chen9Ziyang Han10Jihong Lin11Shuchen Chen12Jinxin Xu13Jinbiao Xie14Mingqiang Kang15Department of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery, Zhongshan Hospital of Xiamen University, School of Medicine Xiamen University Xiamen ChinaDepartment of Cardiothoracic Surgery The Affiliated Hospital of Putian University Putian ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaDepartment of Thoracic Surgery, Zhongshan Hospital of Xiamen University, School of Medicine Xiamen University Xiamen ChinaDepartment of Cardiothoracic Surgery, Putian Pulmonary Hospital Putian ChinaDepartment of Thoracic Surgery Fujian Medical University Union Hospital Fuzhou ChinaABSTRACT Background Neoadjuvant chemoimmunotherapy (nICT) has emerged as a novel and promising treatment model for esophageal squamous cell carcinoma (ESCC). However, the optimal interval to esophagectomy after nICT remains unclear. This study aimed to explore the impact of a prolonged interval (7–10 weeks) on short‐ and long‐term outcomes compared to the standard interval (4–6 weeks). Methods This was a multicenter retrospective cohort analysis, including three centers. Patients were diagnosed with locally advanced ESCC (cT3‐4a or cN+) and received radical resection after at least one cycle of nICT. The primary outcomes were pathological response, disease‐free survival (DFS), and overall survival (OS). Inverse probability of treatment weighting (IPTW) was utilized to balance the baseline characteristics. Results One hundred and seventy patients were included in the study, with 123 in the standard interval group and 47 in the prolonged interval group. After IPTW, the prolonged interval group exhibited a higher pathological complete response (pCR) than the standard group, but the difference was not statistically significant (29.5% vs. 41.5%, p = 0.306). Additionally, although the 3‐year DFS and OS rates were higher in the prolonged interval group, these differences did not reach statistical significance. There were no statistically significant variances observed in terms of intraoperative blood loss, surgical time, postoperative hospital stays, duration of thoracic drainage tube placement, hospital expenses, or postoperative complications. Conclusions Patients demonstrated tolerance for esophagectomy within 4–6 weeks after nICT. Based on the present findings regarding pCR, DFS, and OS, extending the time to surgery beyond 6 weeks was found to be acceptable.https://doi.org/10.1111/1759-7714.70019esophageal squamous cell carcinomainterval to surgerylong‐term survivalneoadjuvant immunochemotherapy(nICT)pathological response |
| spellingShingle | Hui Xu Zhinuan Hong Ye Lin Sunkui Ke Zhen Chen Shuhan Xie Dinghang Chen Kaiming Peng Peipei Zhang Mingduan Chen Ziyang Han Jihong Lin Shuchen Chen Jinxin Xu Jinbiao Xie Mingqiang Kang Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis Thoracic Cancer esophageal squamous cell carcinoma interval to surgery long‐term survival neoadjuvant immunochemotherapy(nICT) pathological response |
| title | Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis |
| title_full | Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis |
| title_fullStr | Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis |
| title_full_unstemmed | Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis |
| title_short | Impact of Interval to Esophagectomy After Neoadjuvant Immunochemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Cohort Analysis |
| title_sort | impact of interval to esophagectomy after neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma a multicenter retrospective cohort analysis |
| topic | esophageal squamous cell carcinoma interval to surgery long‐term survival neoadjuvant immunochemotherapy(nICT) pathological response |
| url | https://doi.org/10.1111/1759-7714.70019 |
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