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Efficacy of neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma: a prospective cohort study with propensity-score matching.

Frontiers in immunology 2025 Vol.16() p. 1711095

Zhang S, Hu A, Sun J, Wei Y, Zhang J, Cai H, Wang G

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[BACKGROUND] This study compared the efficacy of neoadjuvant immunochemotherapy (nICT) followed by surgery versus upfront surgery for locally advanced esophageal squamous cell carcinoma (ESCC).

🔬 핵심 임상 통계 (초록에서 자동 추출 — 원문 검증 권장)
  • p-value p<0.001
  • p-value p=0.002
  • HR 0.31

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BibTeX ↓ RIS ↓
APA Zhang S, Hu A, et al. (2025). Efficacy of neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma: a prospective cohort study with propensity-score matching.. Frontiers in immunology, 16, 1711095. https://doi.org/10.3389/fimmu.2025.1711095
MLA Zhang S, et al.. "Efficacy of neoadjuvant immunochemotherapy in locally advanced esophageal squamous cell carcinoma: a prospective cohort study with propensity-score matching.." Frontiers in immunology, vol. 16, 2025, pp. 1711095.
PMID 41567204

Abstract

[BACKGROUND] This study compared the efficacy of neoadjuvant immunochemotherapy (nICT) followed by surgery versus upfront surgery for locally advanced esophageal squamous cell carcinoma (ESCC).

[METHODS] In this prospective controlled trial (2020-2025), 623 stage II-IIIB ESCC patients were included; 192 received nICT (cisplatin, nab-paclitaxel, sintilimab) before surgery, and 431 underwent direct surgery. Propensity-score matching (PSM) and overlap weighting were used to adjust for baseline confounders.

[RESULTS] After PSM (144 pairs), the nICT group showed significantly improved progression-free survival (PFS; HR = 0.31, p<0.001) and overall survival (OS; HR = 0.42, p=0.002) compared to the upfront surgery group. The nICT group also had higher 1-/3-year PFS (88.8%/84.3% vs. 68.1%/52.8%) and OS rates (94.8%/84.7% vs. 89.6%/65.2%). Sensitivity analysis using overlap weighting confirmed these robust findings (PFS: HR = 0.37, p<0.001; OS: HR = 0.62, p=0.033).

[CONCLUSIONS] For locally advanced ESCC, neoadjuvant immunochemotherapy significantly improves both PFS and OS compared to upfront surgery, establishing it as a highly effective treatment strategy.

MeSH Terms

Humans; Male; Esophageal Squamous Cell Carcinoma; Female; Neoadjuvant Therapy; Middle Aged; Esophageal Neoplasms; Propensity Score; Prospective Studies; Aged; Antineoplastic Combined Chemotherapy Protocols; Treatment Outcome; Paclitaxel; Neoplasm Staging; Adult; Cisplatin; Immunotherapy

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