ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Impact of Adjuvant Immunotherapy on Prognosis in Esophageal Squamous Cell Carcinoma Patients Following Neoadjuvant Immunochemotherapy
Provisionally accepted
Jiayi Geng1*
Bengang Hui2
Mu Teng3Ping Ni4Runmin Jiang2
Xiuyuan Chen1Heng Zhao1Duoji Danzeng4Xizhao Sui1Yun Li1Xun Wang1Jie Lei2- 1Peking University People's Hospital, Beijing, China
- 2Air Force Medical University Tangdu Hospital Department of Thoracic Surgery, Xi'An, China
- 3The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- 4Tibet Autonomous Region People's Hospital, Lhasa, China
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Abstract Introduction: The CheckMate-577 trial confirmed that adjuvant nivolumab significantly prolonged disease-free survival (DFS) in patients with esophageal cancer who had residual disease after neoadjuvant chemoradiotherapy (nCRT). However, whether postoperative adjuvant immunotherapy (AIT) is necessary following neoadjuvant immunochemotherapy (nICT) remains highly controversial. This study aims to explore the efficacy of AIT in esophageal squamous cell carcinoma (ESCC) patients who underwent nICT. Methods: A multicenter, retrospective study was conducted on 323 ESCC patients who underwent nICT followed by R0 resection. Patients were divided into AIT group and non-AT group, with further stratification based on pCR status. Stable inverse probability of treatment weighting (sIPTW) was used to balance baseline characteristics. Primary endpoint was overall survival (OS). Secondary endpoints were disease-free survival (DFS) and cancer-specific survival (CSS). Survival outcomes were analyzed using Kaplan-Meier curves. Results: In overall patients, AIT significantly improved OS (2-year OS: 95.8% vs. 84.4%, P=0.008) and CSS (2-year CSS: 96.8% vs. 89.9%, P=0.036), while no significant survival benefit from AIT was observed for pCR patients. However, in non-pCR patients, AIT significantly improved OS (2-year OS: 93.5% vs. 78.8%, P=0.024) and CSS (2-year CSS: 95.0% vs. 85.9%, P=0.047). No significant differences were observed between adjuvant immunochemotherapy (AICT) and adjuvant immune checkpoint inhibitor monotherapy (AIMT). Conclusion: The study showed that AIT could bring prognosis benefits for patients receiving nICT, especially in non-pCR patients.
Keywords: adjuvant therapy, esophageal squamous cell carcinoma, immunochemotherapy, Immunotherapy, Neoadjuvant Therapy
Received: 29 Oct 2025; Accepted: 10 Feb 2026.
Copyright: © 2026 Geng, Hui, Teng, Ni, Jiang, Chen, Zhao, Danzeng, Sui, Li, Wang and Lei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiayi Geng
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