Abstract Background For patients who achieve pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT), there is no prognostic histological feature due to the absence of viable tumor in the resected specimens. Tertiary lymphoid structures (TLS) in cancer are thought to stimulate antitumor immunity and associated with improved patient survival. We aim to evaluate the prognostic role of TLS in esophageal squamous cell carcinoma (ESCC) patients who had pCR after nCRT. Methods We retrospectively review patients (1) with ESCC, (2) received nCRT, and (3) achieved pCR, in a single medical center from 2011 to 2018. The presence and density of TLS were assessed on hematoxylin and eosin (H&E)-stained slides, which were reviewed pathologists without any clinical information about the patient. The clinical and prognostic relevance of TLS was evaluated. Results A total of 66 patients, including 35 with and 31 without the presence of TLS, were included. There was no significant relationship between the presence of TLS and any clinical factors, including tumor length, clinical tumor stages. In the survival analysis, the 5-yr overall survival rates were 67.7% and 45.7% in patients with and without the presence of TLS, respectively (p = 0.214). The 5-yr distant recurrence-free rates were 60.7% and 55.1% in patients with and without the presence of TLS, respectively (p = 0.402). The 5-yr disease free survival rates were 48.4% and 45.7%, respectively (p = 0.812). Conclusion Unlike its role in predicting patient survival and response to immune checkpoint inhibitors, the presence of TLS did not positively impact prognosis in patients who had ESCC and achieved pCR after nCRT.
Po‐Kuei Hsu (Fri,) studied this question.