Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy

PurposeTo compare the recurrence patterns and survival outcomes between patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) and adjuvant chemoradiotherapy (ACRT).MethodsWe retrospectively analyzed 267 patients with locally advanced ESCC who recei...

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Main Authors: Kunhan Ni, Yixuan Huang, Simiao Lu, Longlin Jiang, Huan Zhang, Wenwu He, Chenghao Wang, Qiang Zhou, Haojun Li, Jialong Li, Kangning Wang, Guangyuan Liu, Qiang Fang, Lin Peng, Xuefeng Leng, Yongtao Han
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Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1604808/full
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author Kunhan Ni
Kunhan Ni
Yixuan Huang
Simiao Lu
Longlin Jiang
Huan Zhang
Wenwu He
Chenghao Wang
Qiang Zhou
Haojun Li
Jialong Li
Kangning Wang
Guangyuan Liu
Qiang Fang
Lin Peng
Xuefeng Leng
Yongtao Han
Yongtao Han
author_facet Kunhan Ni
Kunhan Ni
Yixuan Huang
Simiao Lu
Longlin Jiang
Huan Zhang
Wenwu He
Chenghao Wang
Qiang Zhou
Haojun Li
Jialong Li
Kangning Wang
Guangyuan Liu
Qiang Fang
Lin Peng
Xuefeng Leng
Yongtao Han
Yongtao Han
author_sort Kunhan Ni
collection DOAJ
description PurposeTo compare the recurrence patterns and survival outcomes between patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) and adjuvant chemoradiotherapy (ACRT).MethodsWe retrospectively analyzed 267 patients with locally advanced ESCC who received treatment at Sichuan Cancer Hospital and Institute (Chengdu, China) between January 2018 and December 2020. Based on different treatment protocols, the patients were divided into two groups: NCRT (n=181) and ACRT (n=86). After propensity score matching, each group included 74 patients. This study compared the recurrence types, sites, frequencies, and timing, as well as overall survival (OS), disease-free survival (DFS), and prognostic risk factors between the two groups.ResultsThe recurrence rates in the NCRT and ACRT groups were 59.5% (44/74) and 33.8% (25/74), respectively; the difference was statistically significant (P=0.002). Recurrences primarily occurred within 2 years following esophagectomy. The ACRT group had a higher 3-year OS rate than the NCRT group (67.8% versus [vs.] 50.6%, respectively; P=0.019). In the subgroup of patients with local recurrence, the 3-year OS rate was higher in the NCRT group compared to the ACRT group (53.8% vs. 0%, respectively; P=0.029). In terms of DFS, the ACRT group exhibited better results than the NCRT group (P<0.001). Multivariate analysis revealed that pathological N staging was an independent risk factor affecting the OS prognosis of patients in the NCRT group. Margin status and pathological T staging were identified as independent risk factors influencing OS in the ACRT group, while sex and treatment regimen were independent risk factors affecting DFS in patients with postoperative pathological lymph node positivity.ConclusionThere was significant difference in the OS and DFS prognosis of patients with ESCC treated with NCRT and ACRT. Recurrence primarily occurs within 2 years following esophagectomy. The recurrence rate was higher in the NCRT group compared to the ACRT group. Patients with early recurrence had a poorer survival prognosis compared to those with late recurrence. Pathological N staging was identified as an independent risk factor affecting OS in the NCRT group. Furthermore, margin status and pathological T staging were independent risk factors influencing OS in the ACRT group.
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spelling doaj-art-2c6dfbd9e93047b8a7e7791bc9dfdc002025-08-20T03:20:12ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.16048081604808Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapyKunhan Ni0Kunhan Ni1Yixuan Huang2Simiao Lu3Longlin Jiang4Huan Zhang5Wenwu He6Chenghao Wang7Qiang Zhou8Haojun Li9Jialong Li10Kangning Wang11Guangyuan Liu12Qiang Fang13Lin Peng14Xuefeng Leng15Yongtao Han16Yongtao Han17Department of Thoracic Surgery, the Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaDepartment of Thoracic Surgery, the Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, ChinaDepartment of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China (UESTC), Chengdu, ChinaPurposeTo compare the recurrence patterns and survival outcomes between patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) and adjuvant chemoradiotherapy (ACRT).MethodsWe retrospectively analyzed 267 patients with locally advanced ESCC who received treatment at Sichuan Cancer Hospital and Institute (Chengdu, China) between January 2018 and December 2020. Based on different treatment protocols, the patients were divided into two groups: NCRT (n=181) and ACRT (n=86). After propensity score matching, each group included 74 patients. This study compared the recurrence types, sites, frequencies, and timing, as well as overall survival (OS), disease-free survival (DFS), and prognostic risk factors between the two groups.ResultsThe recurrence rates in the NCRT and ACRT groups were 59.5% (44/74) and 33.8% (25/74), respectively; the difference was statistically significant (P=0.002). Recurrences primarily occurred within 2 years following esophagectomy. The ACRT group had a higher 3-year OS rate than the NCRT group (67.8% versus [vs.] 50.6%, respectively; P=0.019). In the subgroup of patients with local recurrence, the 3-year OS rate was higher in the NCRT group compared to the ACRT group (53.8% vs. 0%, respectively; P=0.029). In terms of DFS, the ACRT group exhibited better results than the NCRT group (P<0.001). Multivariate analysis revealed that pathological N staging was an independent risk factor affecting the OS prognosis of patients in the NCRT group. Margin status and pathological T staging were identified as independent risk factors influencing OS in the ACRT group, while sex and treatment regimen were independent risk factors affecting DFS in patients with postoperative pathological lymph node positivity.ConclusionThere was significant difference in the OS and DFS prognosis of patients with ESCC treated with NCRT and ACRT. Recurrence primarily occurs within 2 years following esophagectomy. The recurrence rate was higher in the NCRT group compared to the ACRT group. Patients with early recurrence had a poorer survival prognosis compared to those with late recurrence. Pathological N staging was identified as an independent risk factor affecting OS in the NCRT group. Furthermore, margin status and pathological T staging were independent risk factors influencing OS in the ACRT group.https://www.frontiersin.org/articles/10.3389/fonc.2025.1604808/fullesophageal squamous cell carcinomaesophagectomychemoradiotherapyrecurrence patternspropensity score matching
spellingShingle Kunhan Ni
Kunhan Ni
Yixuan Huang
Simiao Lu
Longlin Jiang
Huan Zhang
Wenwu He
Chenghao Wang
Qiang Zhou
Haojun Li
Jialong Li
Kangning Wang
Guangyuan Liu
Qiang Fang
Lin Peng
Xuefeng Leng
Yongtao Han
Yongtao Han
Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
Frontiers in Oncology
esophageal squamous cell carcinoma
esophagectomy
chemoradiotherapy
recurrence patterns
propensity score matching
title Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
title_full Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
title_fullStr Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
title_full_unstemmed Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
title_short Comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
title_sort comparison of recurrence patterns between patients with thoracic esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and postoperative adjuvant chemoradiotherapy
topic esophageal squamous cell carcinoma
esophagectomy
chemoradiotherapy
recurrence patterns
propensity score matching
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1604808/full
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