Pathologic responses and surgical outcomes after neoadjuvant immunochemotherapy versus neoadjuvant chemoradiotherapy in patients with locally advanced esophageal squamous cell carcinoma

作者：Lei Xu, Xiufeng Wei, Can-jun Li, Zhao-yang Yang, Yongkui Yu, Haomiao Li, Hounai Xie, Yafan Yang, Weiwei Jing, Zhen Wang, Xiaozheng Kang, Rui‐xiang Zhang, Jianjun Qin, Liyan Xue, Nan Bi, Xiankai Chen, Yin Li · 发表于：Frontiers in Immunology · 年份：2022 · DOI：10.3389/fimmu.2022.1052542 · 被引用次数：49 · 研究领域：Esophageal Cancer Research and Treatment、Colorectal and Anal Carcinomas、Cancer Immunotherapy and Biomarkers

Background: Currently, the role of immunotherapy in neoadjuvant setting for patients with locally advanced esophageal squamous cell carcinoma (ESCC) is gradually attracting attention. Few studies compared the efficacy of neoadjuvant immunochemotherapy (NICT) and neoadjuvant chemoradiotherapy (NCRT). Our study aimed to compare treatment response and postoperative complications after NICT followed by surgery with that after conventional NCRT in patients with locally advanced ESCC. Methods: Of 468 patients with locally advanced ESCC, 154 received conventional NCRT, whereas 314 received NICT. Treatment response, postoperative complications and mortality between two groups were compared. Pathological response of primary tumor was evaluated using the Mandard tumor regression grade (TRG) scoring system. Pathological complete response (pCR) of metastatic lymph nodes (LNs) was defined as no viable tumor cell within all resected metastatic LNs. According to regression directionality, tumor regression pattern was summarized into four categories: type I, regression toward the lumen; type II, regression toward the invasive front; type III, concentric regression; and type IV, scattered regression. Inverse probability propensity score weighting was performed to minimize the influence of confounding factors. Results: After adjusting for baseline characteristics, the R0 resection rates (90.9% vs. 89.0%, P=0.302) and pCR (ypT0N0) rates (29.8% vs. 34.0%, P=0.167) were comparable between two gro...