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

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

SUBMITTER: Zhang S 

PROVIDER: S-EPMC12816230 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature