Treatment strategy after neoadjuvant PD-1 inhibitor combined with chemotherapy for patients with locally advanced esophageal squamous cell carcinoma
- VernacularTitle:局部晚期食管鳞癌新辅助PD-1单抗联合化疗后的治疗策略
- Author:
Shifa ZHANG
1
,
2
;
Haibo CAI
3
,
4
;
Liji CHEN
5
Author Information
1. 1.Department of Thoracic Surgery, The First People'
2. s Hospital of Jining, Jining, 272000, Shandong, P. R. China 2. Institute of Thoracic Surgery, Jining Institute of Medical Science, Jining, 272000, Shandong, P. R. China
3. Department of Thoracic Surgery, The First People'
4. s Hospital of Jining, Jining, 272000, Shandong, P. R. China
5. Jining Medical University, Jining, 272000, Shandong, P. R. China
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
surgical treatment;
immunotherapy;
programmed cell death-1;
chemotherapy;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(02):216-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the necessity of further surgery for patients with locally advanced esophageal squamous cell carcinoma following treatment with the programmed cell death-1 (PD-1) inhibitor combined with chemotherapy, and to assess its impact on survival. Methods Patients with stage ⅡA to ⅢB esophageal squamous cell carcinoma who received immunotherapy combined with chemotherapy at our hospital from January 2020 to June 2022 were selected for this study. Based on whether they underwent surgery after receiving PD-1 inhibitor combined with chemotherapy, patients were divided into a surgery group and a non-surgery group. We compared the general clinical data, side effects, clinical complete response rates, progression-free survival (PFS), and overall survival (OS) between the two groups. Results A total of 58 patients were included in the study, comprising 45 males and 13 females, with an average age of (65.5±6.9) years. There were no statistical differences in general clinical data or adverse reactions between the two groups. Univariate analysis revealed that the objective response rate and surgery were significantly associated with PFS (P<0.05). Binary logistic regression analysis showed that surgery was the only independent risk factor for PFS (P=0.003). Kaplan-Meier survival analysis showed that the PFS and OS in the surgery group were significantly higher than those in the non-surgery group (HR=0.13, 95%CI 0.036 to 0.520, P＜0.001; HR=0.17, 95%CI 0.045 to 0.680, P=0.004). Conclusion After treatment with the PD-1 inhibitor combined with chemotherapy, patients with locally advanced esophageal squamous cell carcinoma still require surgical intervention to achieve improved PFS and OS.
