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Background <p>Presently, there is a paucity of data supporting the efficacy of three-field lymph node dissection following neoadjuvant treatment. This study was designed to investigate the therapeutic efficacy and safety of neoadjuvant chemoimmunotherapy compared with the conventional neoadjuvant chemoradiotherapy regimen, both in conjunction with three-field lymph node dissection. </p> Methods <p>Patients who underwent esophageal cancer surgery from June 2018 to June 2022 were evaluated. The primary endpoints focused on surgery-related complications and the degree of tumor regression. Additionally, the secondary endpoints included 2-year overall survival (OS) rates and recurrence-free survival (RFS) rates.</p> Results <p>Fifty-seven patients were recruited, with 30 assigned to the neoadjuvant chemoradiotherapy (NCRT) group and 27 to the neoadjuvant chemoimmunotherapy (NICT) group. The NCRT group had a higher complication rate than the NICT group did (53.3% versus 44.4%, <i>p</i> = 0.503). Notably, the incidence of complications rated above Clavien–Dindo grade III was greater in the NCRT group (13.3% versus 7.4%, <i>p</i> = 0.433). The NCRT group had a higher pathological complete response (pCR) rate (33.3% versus 18.5%, <i>p</i> = 0.205), and a major pathological response (MPR) rate (53.3% versus 29.6%, <i>p </i>= 0.070). However, there was no significant difference in the 2-year overall survival (OS) rate (86.7% versus 74.1%, HR = 2.026; 95%CI,0.593-6.923; <i>p </i>= 0.250) or the 2-year recurrence-free survival (RFS) rate (76.7% versus 63.0%, HR = 1.807; 95%CI,0.688-4.749; p = 0.220) between the NCRT and NICT groups.</p> Conclusions <p>Neoadjuvant chemoradiotherapy is associated with more postoperative complications, whereas the two treatment approaches yielded comparable prognoses. Three-field lymph node dissection after neoadjuvant therapy is proven safe and feasible in this study.</p>

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Neoadjuvant chemoradiotherapy versus neoadjuvant chemoimmunotherapy for esophageal squamous cell carcinoma with three-field lymph node dissection

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月22日

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  • FengNian Zhuang,
  • JunPeng Lin,
  • FangZhou Lin,
  • XiaoFeng Chen,
  • PeiYuan Wang,
  • Feng Wang,
  • ShuoYan Liu,
  • Hui Lin

摘要

Background

Presently, there is a paucity of data supporting the efficacy of three-field lymph node dissection following neoadjuvant treatment. This study was designed to investigate the therapeutic efficacy and safety of neoadjuvant chemoimmunotherapy compared with the conventional neoadjuvant chemoradiotherapy regimen, both in conjunction with three-field lymph node dissection.

Methods

Patients who underwent esophageal cancer surgery from June 2018 to June 2022 were evaluated. The primary endpoints focused on surgery-related complications and the degree of tumor regression. Additionally, the secondary endpoints included 2-year overall survival (OS) rates and recurrence-free survival (RFS) rates.

Results

Fifty-seven patients were recruited, with 30 assigned to the neoadjuvant chemoradiotherapy (NCRT) group and 27 to the neoadjuvant chemoimmunotherapy (NICT) group. The NCRT group had a higher complication rate than the NICT group did (53.3% versus 44.4%, p = 0.503). Notably, the incidence of complications rated above Clavien–Dindo grade III was greater in the NCRT group (13.3% versus 7.4%, p = 0.433). The NCRT group had a higher pathological complete response (pCR) rate (33.3% versus 18.5%, p = 0.205), and a major pathological response (MPR) rate (53.3% versus 29.6%, p = 0.070). However, there was no significant difference in the 2-year overall survival (OS) rate (86.7% versus 74.1%, HR = 2.026; 95%CI,0.593-6.923; p = 0.250) or the 2-year recurrence-free survival (RFS) rate (76.7% versus 63.0%, HR = 1.807; 95%CI,0.688-4.749; p = 0.220) between the NCRT and NICT groups.

Conclusions

Neoadjuvant chemoradiotherapy is associated with more postoperative complications, whereas the two treatment approaches yielded comparable prognoses. Three-field lymph node dissection after neoadjuvant therapy is proven safe and feasible in this study.