Tailoring the Extent of Lymphadenectomy for Esophageal Squamous Cell Carcinoma: Insights From a Comparative Study of Neoadjuvant Chemo‐Immunotherapy and Surgery Cohort
Comparative study evaluates lymphadenectomy extent in patients under chemo-immunotherapy and surgery, indicating survival implications.
Key Points
This study aims to determine how the count of examined lymph nodes affects overall survival in esophageal squamous cell carcinoma under different treatment strategies.
Analyzed 621 esophageal squamous cell carcinoma patients who underwent R0 resection with or without neoadjuvant chemo-immunotherapy.
Stratified patients into surgery alone and NACI groups, applying propensity score matching for balanced comparison.
Used Cox regression models to analyze the relationship between examined lymph nodes count and overall survival.
In the NACI cohort, ELN counts ≤ 23 and > 31 were associated with worse overall survival (HR = 2.29, 95% CI 1.11-4.71, p = 0.024; HR = 2.71, 95% CI 1.17-6.26, p = 0.020).
SA cohort showed continuous survival benefits with higher ELN counts.
Single-cell sequencing revealed enriched populations of activated cytotoxic T cells in metastasis-negative lymph nodes in the NACI group.