Abstract Immune checkpoint inhibitors (ICIs) have recently emerged as promising first-line treatments. Among stage IVb esophageal squamous cell carcinoma (ESCC) cases, gastric wall metastasis is rare, and conversion surgery after ICI therapy in such cases is extremely uncommon. We report a case of stage IVb ESCC with gastric intramural metastasis (IM) successfully treated with conversion surgery following ICI-based chemoimmunotherapy, along with a review of the relevant literature. A 73-year-old man was diagnosed with ESCC with gastric IM (Mt, SCC, cT3brN1M1b IM-St, stage IVb). He received three cycles of combination immunochemotherapy with cisplatin, 5-fluorouracil, and pembrolizumab. Conversion surgery was subsequently performed. Pathological examination demonstrated a complete response, with no residual carcinoma in either the esophagus or the gastric wall. The patient remains recurrence-free 8 months postoperatively. Further studies are warranted to clarify the optimal criteria for assessing ICI treatment response and determining indications for conversion surgery in such cases.
Kitano et al. (Tue,) studied this question.