Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Aug 5;25(1):1270.
doi: 10.1186/s12885-025-14682-z.

Neoadjuvant immunochemotherapy versus neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for resectable esophageal squamous cell carcinoma: a clinical retrospective study

Jiazhen Chen  1 , Chuanwang Miao  2 , Xiaoyue Wang  3 , Liying Yang  2   4 , Cunliang Wang  5 , Yuanji Chen  2 , Dan Zong  1 , XuDong Hu  6 , Xia He  7   8
Affiliations
Comparative Study

Neoadjuvant immunochemotherapy versus neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy for resectable esophageal squamous cell carcinoma: a clinical retrospective study

Jiazhen Chen et al. BMC Cancer. .

Abstract

Background: As neoadjuvant therapies become increasingly crucial in the management of esophageal squamous cell carcinoma (ESCC), improving local control, R0 resection rates, and overall survival, determining the optimal neoadjuvant strategy remains a priority. This study retrospectively assesses the efficacy and safety of neoadjuvant immunochemotherapy (NICT), chemoradiotherapy (NCRT), and chemotherapy (NCT) in operable ESCC.

Methods: Analyzing preoperative clinical data from resectable ESCC patients treated with NICT, NCRT, or NCT at Shandong Cancer Hospital from January 2018 to August 2022, we focused on surgical complications, pathological responses, and survival outcomes.

Results: Data from 300 patients (91 NICT, 113 NCRT, 96 NCT) were evaluated. The NICT group showed a lower incidence of surgical complications compared to NCRT (17.6% vs. 36.3%, p = 0.003) and was on par with NCT (17.6% vs. 22.9%, p = 0.365). NICT had less favorable complete pathological response rates than NCRT (p < 0.001) but outperformed NCT. Notably, the NICT cohort achieved superior 2-year recurrence-free (81.3%) and overall survival (93.4%) compared to NCRT (73.5% and 84.1%, p = 0.187 and p = 0.043) and NCT (44.8% and 61.5%, p < 0.001 for both).

Conclusion: Despite a slightly lower rate of pathological remission, NICT significantly reduced surgical complications and improved survival outcomes. It presents a compelling option in the neoadjuvant treatment of resectable ESCC, with the potential to supersede NCRT and NCT.

Keywords: Chemoradiotherapy; Esophageal squamous cell carcinoma; Immunotherapy; Neoadjuvant therapy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and received approval from the Ethics Committee of the Shandong First Medical University Affiliated Tumor Hospital (file number: SDTHEC2024003171). All participants signed informed consent prior to their inclusion in the study. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of our study
Fig. 2
Fig. 2
Comparison of postoperative complications in the NICT, NCRT and NCT groups. The Chi-square test or Fisher’s exact test was utilized to determine statistical significance, with P-values indicating significant differences highlighted in red font
Fig. 3
Fig. 3
Comparison of pathological outcomes in the NICT, NCRT and NCT groups. Statistical significance was assessed using either the Chi-square test or Fisher’s exact test, with P-values indicating substantial differences emphasized in red typeface
Fig. 4
Fig. 4
The Kaplan-Meier plots illustrate the RFS (A) and OS (B) for patients within the NICT, NCRT and NCT groups, with comparisons conducted using the log-rank test
See this image and copyright information in PMC

References

    1. Visaggi P, Barberio B, Ghisa M, Ribolsi M, Savarino V, Fassan M, et al. Modern diagnosis of early esophageal cancer: from blood biomarkers to advanced endoscopy and artificial intelligence. Cancers. 2021;13:3162. 10.3390/cancers13133162. - PMC - PubMed
    1. Kovaleva O, Podlesnaya P, Rashidova M, Samoilova D, Petrenko A, Mochalnikova V, et al. Prognostic significance of the Microbiome and stromal cells phenotype in esophagus squamous cell carcinoma. Biomedicines. 2021;9:743. 10.3390/biomedicines9070743. - PMC - PubMed
    1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108. 10.3322/caac.21262. - PubMed
    1. Zeng H, Chen W, Zheng R, Zhang S, Ji JS, Zou X, et al. Changing cancer survival in China during 2003–15: a pooled analysis of 17 population-based cancer registries. Lancet Glob Health. 2018;6:e555–67. 10.1016/S2214-109X(18)30127-X. - PubMed
    1. Demarest CT, Chang AC. The landmark series: multimodal therapy for esophageal cancer. Ann Surg Oncol. 2021;28:3375–82. 10.1245/s10434-020-09565-5. - PubMed

Publication types