Conversion Surgery Following Immunochemotherapy in Initially Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma-A Real-World Multicenter Study (RICE-Retro)

Huang, Shujie1,2; Wu, Hansheng3; Cheng, Chao4; Zhou, Ming5; Xu, Enwu6; Lin, Wanli7; Wang, Guangsuo8; Tang, Jiming1; Ben, Xiaosong1; Zhang, Dongkun1; Xie, Liang1; Zhou, Haiyu1; Chen, Gang1; Zhuang, Weitao1,2; Tang, Yong1; Xu, Fangping9; Du, Zesen10; Xie, Zefeng3; Wang, Feixiang5; He, Zhe6; Zhang, Hai7; Sun, Xuefeng8; Li, Zijun11,12; Sun, Taotao13; Liu, Jianhua14; Yang, Shuhan15; Xie, Songxi16; Fu, Junhui10; Qiao, Guibin1,2,17

2022-07-13

10.3389/fimmu.2022.935374

Frontiers in Immunology   Impact Factor & Quartile

1664-3224

PurposeThe present study sets out to evaluate the feasibility, safety, and effectiveness of conversion surgery following induction immunochemotherapy for patients with initially unresectable locally advanced esophageal squamous cell carcinoma (ESCC) in a real-world scenario. Materials and MethodsIn this multi-center, real-world study (NCT04822103), patients who had unresectable ESCC disease were enrolled across eight medical centers in China. All patients received programmed death receptor-1 (PD-1) inhibitor plus chemotherapy every 3 weeks for at least two cycles. Patients with significant relief of cancer-related clinical symptoms and radiological responsive disease were deemed surgical candidates. Feasibility and safety profile of immunochemotherapy plus conversion surgery, radiological and pathological tumor responses, as well as short-term survival outcomes were evaluated. Moreover, data of an independent ESCC cohort receiving induction chemotherapy (iC) were compared. ResultsOne hundred and fifty-five patients were enrolled in the final analysis. Esophagectomy was offered to 116 patients, yielding a conversion rate of 74.8%. R0 resection rate was 94%. Among the 155 patients, 107 (69.0%) patients experienced at least one treatment-related adverse event (TRAE) and 45 (29.0%) patients reported grade 3 and above TRAEs. Significant differences in responsive disease rate were observed between iC cohort and induction immunochemotherapy (iIC) cohort [objective response rate: iIC: 63.2% vs. iC: 47.7%, p = 0.004; pathological complete response: iIC: 22.4% vs. iC: 6.7%, p = 0.001). Higher anastomosis fistula rate was observed in the iC group (19.2%) compared with the iIC group (4%). Furthermore, Significantly higher event-free survival was observed in those who underwent conversion surgery. ConclusionOur results supported that conversion surgery following immunochemotherapy is feasible and safe for patients with initially unresectable locally advanced ESCC. Both radiological and pathological response rates were significantly higher in the iIC cohort compared with those in the traditional iC cohort.

esophageal squamous cell carcinoma conversion surgery immunotherapy effectiveness real-world study

SCI

English

Others

Immunology

Immunology

WOS:000832803100001

FRONTIERS MEDIA SA

Web of Science

1.Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Thorac Surg, Guangzhou, Peoples R China
2.Shantou Univ Med Coll, Shantou, Peoples R China
3.Shantou Univ, Affiliated Hosp 1, Med Coll, Dept Thorac Surg, Shantou, Peoples R China
4.Sun Yat Sen University, Affiliated Hosp 1, Dept Thorac Surg, Guangzhou, Peoples R China
5.Guangzhou Med Univ, Affiliated Canc Hosp, Dept Thorac Surg, Guangzhou, Peoples R China
6.Gen Hosp Southern Theater Command, Dept Thorac Surg, PLA, Guangzhou, Peoples R China
7.Gaozhou Peoples Hosp, Dept Thorac Surg, Gaozhou, Peoples R China
8.Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Affiliated Hosp 1,Shenzhen Inst Resp Dis,Clin Med, Shenzhen, Peoples R China
9.Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Pathol, Lab Med, Guangzhou, Peoples R China
10.Shantou Cent Hosp, Dept Surg Oncol, Shantou, Peoples R China
11.Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Gen Practice, Guangzhou, Peoples R China
12.Guangdong Prov Peoples Hosp, Guangdong Prov Geriatr Inst, Guangdong Acad Med Sci, Guangzhou, Peoples R China
13.Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, WeiLun PET Ctr, Dept Nucl Med, Guangzhou, Peoples R China
14.Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Oncol, Guangzhou, Peoples R China
15.South China Univ Technol, Sch Med, Chron Dis Lab, Guangzhou, Peoples R China
16.Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Radiat Oncol, Guangzhou, Peoples R China
17.Southern Med Univ, Sch Clin Med 2, Guangzhou, Peoples R China

Huang, Shujie,Wu, Hansheng,Cheng, Chao,et al. Conversion Surgery Following Immunochemotherapy in Initially Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma-A Real-World Multicenter Study (RICE-Retro)[J]. Frontiers in Immunology,2022,13.

Huang, Shujie.,Wu, Hansheng.,Cheng, Chao.,Zhou, Ming.,Xu, Enwu.,...&Qiao, Guibin.(2022).Conversion Surgery Following Immunochemotherapy in Initially Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma-A Real-World Multicenter Study (RICE-Retro).Frontiers in Immunology,13.

Huang, Shujie,et al."Conversion Surgery Following Immunochemotherapy in Initially Unresectable Locally Advanced Esophageal Squamous Cell Carcinoma-A Real-World Multicenter Study (RICE-Retro)".Frontiers in Immunology 13(2022).