Chufeng Zeng, Guozhen Yang, Lingyu Tan, Kun Li, Wenyu Zhai, Xin Zhang, Longgao Liu, Weihua Wu, Xiaodong Su, Jianhua Fu, Xu Zhang, Wei Wei Liu
{"title":"食管鳞状细胞癌伴非区域颈部淋巴结转移的新辅助化疗免疫治疗：一项回顾性初步研究。","authors":"Chufeng Zeng, Guozhen Yang, Lingyu Tan, Kun Li, Wenyu Zhai, Xin Zhang, Longgao Liu, Weihua Wu, Xiaodong Su, Jianhua Fu, Xu Zhang, Wei Wei Liu","doi":"10.3389/fimmu.2025.1611108","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) with non-regional cervical lymph node metastasis (CLNM) poses significant therapeutic challenges due to lack of consensus in guidelines and poor outcomes associated with conventional treatment modalities. Recent studies have demonstrated promising efficacy of combined immunotherapy, chemotherapy, and surgery in ESCC; however, the role of this multimodal approach in managing non-regional CLNM-historically considered inoperable-remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 15 patients with thoracic ESCC and non-regional CLNM who underwent neoadjuvant chemoimmunotherapy (nCIT), followed by McKeown esophagectomy with three-field lymphadenectomy between 2020 and 2024. CLNM was confirmed via ultrasound-guided biopsy. Data on pathological response, safety, and survival outcomes were collected and analyzed. Survival analysis was performed using the Kaplan-Meier method.</p><p><strong>Results: </strong>A pathological complete response (pCR) in CLNM was achieved in 93.3% of patients, while the Total pCR (ypT0N0M0) rate (clearance of both primary tumor and metastatic lymph node) was 33.3%. At a median follow-up of 18.0 months, the 1-year disease-free survival (DFS) rate was 91.7%. One patient died during the follow-up period. Postoperative complications occurred in 73.3% of patients, predominantly respiratory events such as atelectasis and pneumonia; only one patient experienced a grade 4 event. Treatment-related adverse events (TRAEs) were mild, with no grade ≥3 TRAEs observed; anemia was the most common TRAEs, occurring in 46.7% of patients.</p><p><strong>Conclusion: </strong>nCIT induces a high cervical nodal response in ESCC with non-regional CLNM and may redefine surgical eligibility for patients with non-regional metastases. The observed 1-year DFS of 91.7% is promising, though long-term outcomes require further validation through prospective studies.</p>","PeriodicalId":12622,"journal":{"name":"Frontiers in Immunology","volume":"16 ","pages":"1611108"},"PeriodicalIF":5.9000,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479515/pdf/","citationCount":"0","resultStr":"{\"title\":\"Neoadjuvant chemoimmunotherapy for esophageal squamous cell carcinoma with non-regional cervical lymph node metastasis: a retrospective pilot study.\",\"authors\":\"Chufeng Zeng, Guozhen Yang, Lingyu Tan, Kun Li, Wenyu Zhai, Xin Zhang, Longgao Liu, Weihua Wu, Xiaodong Su, Jianhua Fu, Xu Zhang, Wei Wei Liu\",\"doi\":\"10.3389/fimmu.2025.1611108\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) with non-regional cervical lymph node metastasis (CLNM) poses significant therapeutic challenges due to lack of consensus in guidelines and poor outcomes associated with conventional treatment modalities. Recent studies have demonstrated promising efficacy of combined immunotherapy, chemotherapy, and surgery in ESCC; however, the role of this multimodal approach in managing non-regional CLNM-historically considered inoperable-remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included 15 patients with thoracic ESCC and non-regional CLNM who underwent neoadjuvant chemoimmunotherapy (nCIT), followed by McKeown esophagectomy with three-field lymphadenectomy between 2020 and 2024. CLNM was confirmed via ultrasound-guided biopsy. Data on pathological response, safety, and survival outcomes were collected and analyzed. Survival analysis was performed using the Kaplan-Meier method.</p><p><strong>Results: </strong>A pathological complete response (pCR) in CLNM was achieved in 93.3% of patients, while the Total pCR (ypT0N0M0) rate (clearance of both primary tumor and metastatic lymph node) was 33.3%. At a median follow-up of 18.0 months, the 1-year disease-free survival (DFS) rate was 91.7%. One patient died during the follow-up period. Postoperative complications occurred in 73.3% of patients, predominantly respiratory events such as atelectasis and pneumonia; only one patient experienced a grade 4 event. Treatment-related adverse events (TRAEs) were mild, with no grade ≥3 TRAEs observed; anemia was the most common TRAEs, occurring in 46.7% of patients.</p><p><strong>Conclusion: </strong>nCIT induces a high cervical nodal response in ESCC with non-regional CLNM and may redefine surgical eligibility for patients with non-regional metastases. The observed 1-year DFS of 91.7% is promising, though long-term outcomes require further validation through prospective studies.</p>\",\"PeriodicalId\":12622,\"journal\":{\"name\":\"Frontiers in Immunology\",\"volume\":\"16 \",\"pages\":\"1611108\"},\"PeriodicalIF\":5.9000,\"publicationDate\":\"2025-09-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479515/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fimmu.2025.1611108\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fimmu.2025.1611108","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Neoadjuvant chemoimmunotherapy for esophageal squamous cell carcinoma with non-regional cervical lymph node metastasis: a retrospective pilot study.
Background: Esophageal squamous cell carcinoma (ESCC) with non-regional cervical lymph node metastasis (CLNM) poses significant therapeutic challenges due to lack of consensus in guidelines and poor outcomes associated with conventional treatment modalities. Recent studies have demonstrated promising efficacy of combined immunotherapy, chemotherapy, and surgery in ESCC; however, the role of this multimodal approach in managing non-regional CLNM-historically considered inoperable-remains unclear.
Methods: This retrospective cohort study included 15 patients with thoracic ESCC and non-regional CLNM who underwent neoadjuvant chemoimmunotherapy (nCIT), followed by McKeown esophagectomy with three-field lymphadenectomy between 2020 and 2024. CLNM was confirmed via ultrasound-guided biopsy. Data on pathological response, safety, and survival outcomes were collected and analyzed. Survival analysis was performed using the Kaplan-Meier method.
Results: A pathological complete response (pCR) in CLNM was achieved in 93.3% of patients, while the Total pCR (ypT0N0M0) rate (clearance of both primary tumor and metastatic lymph node) was 33.3%. At a median follow-up of 18.0 months, the 1-year disease-free survival (DFS) rate was 91.7%. One patient died during the follow-up period. Postoperative complications occurred in 73.3% of patients, predominantly respiratory events such as atelectasis and pneumonia; only one patient experienced a grade 4 event. Treatment-related adverse events (TRAEs) were mild, with no grade ≥3 TRAEs observed; anemia was the most common TRAEs, occurring in 46.7% of patients.
Conclusion: nCIT induces a high cervical nodal response in ESCC with non-regional CLNM and may redefine surgical eligibility for patients with non-regional metastases. The observed 1-year DFS of 91.7% is promising, though long-term outcomes require further validation through prospective studies.
期刊介绍：
Frontiers in Immunology is a leading journal in its field, publishing rigorously peer-reviewed research across basic, translational and clinical immunology. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Frontiers in Immunology is the official Journal of the International Union of Immunological Societies (IUIS). Encompassing the entire field of Immunology, this journal welcomes papers that investigate basic mechanisms of immune system development and function, with a particular emphasis given to the description of the clinical and immunological phenotype of human immune disorders, and on the definition of their molecular basis.
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