2070 - Survival Outcomes of Adjuvant Immunotherapy after Neoadjuvant Chemoimmunotherapy Followed by Esophagectomy in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma
Presenter(s)
H. Ge1, S. Yang2, X. Zheng3, W. Zhang4, W. Huang5, H. Liu6, and X. M. Wang7; 1Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China, 2Zhengzhou University Affiliated Cancer Hospital, Henan Cancer Hospital, Zhengzhou, Henan, China, 3Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China, 4Tianjin Medical University Cancer Institute & Hospital, Tianjin, China, 5Shandong Cancer Hospital & Institute, Jinan, Shandong, China, 6Hunan Cancer Hospital/the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, 7Department of Radiation Oncology, Anyang Tumor Hospital, Anyang, China
Purpose/Objective(s): This study aimed to evaluate the survival impact of adjuvant immunotherapy (aIT) in patients with resectable locally advanced esophageal squamous cell carcinoma (LA-ESCC) who underwent neoadjuvant chemoimmunotherapy (nCIT) followed by esophagectomy.
Materials/Methods: In this multicenter retrospective cohort study, 446 patients with LA-ESCC treated with nCIT between June 2019 and December 2023 at five major cancer centers in high-incidence regions of China were analyzed. Patients were categorized into aIT (n=168) or observation (non-aIT, n=278) groups. Primary endpoints were overall survival (OS) and event-free survival (EFS), assessed using Kaplan-Meier curves and log-rank tests. Propensity score matching (PSM) and multivariable Cox regression models were used to adjust for confounding variables and identify independent prognostic factors.
Results: After PSM, 324 patients were included in the final analysis. The median follow-up duration was 42.0 months in the aIT group and 44.7 months in the non-aIT group. The 3-year OS rate was higher in the aIT group than in the non-aIT group (78.98% vs. 70.47%), although the difference did not reach statistical significance (HR = 1.392; 95% CI, 0.915–2.117; P = 0.120). The 3-year EFS rate was comparable between the two groups (70.42% vs. 70.23%; HR = 1.057; 95% CI, 0.714–1.565; P = 0.781). Multivariate analysis identified R1 resection, non-pCR status, and the presence of vascular tumor thrombus as independent adverse prognostic factors for OS.
Conclusion: This study demonstrates that adjuvant immunotherapy does not provide a significant improvement in OS or EFS after nCIT in resectable LA-ESCC.