{
  "abstract": "Background: The optimal local treatment strategy for locally advanced esophageal squamous cell carcinoma (LA-ESCC) following neoadjuvant immunochemotherapy (NICT) remains controversial. This study aimed to compare the survival outcomes and recurrence patterns of radical surgery and definitive radiotherapy (RT) following NICT in patients with LA-ESCC.\n\nMethods: Patients with LA-ESCC who underwent NICT (2019–2023) were enrolled and categorized into surgery or RT groups. Propensity score matching (PSM) and Kaplan-Meier methods were used to estimate progression-free survival (PFS) and overall survival (OS). The differences in recurrence patterns between the two groups were compared.\n\nResults: A total of 278 patients were included, comprising 218 (78.4%) and 60 (21.6%) patients in the surgery and RT groups, respectively. After PSM, the surgery group (n=117) maintained a significant OS benefit over the RT group (n=60) (3-year OS rates: 72.1% vs. 59.5%; P = 0.028), whereas the PFS rates were comparable between the two groups (3-year PFS rates: 59.4% vs. 46.9%; P = 0.12). For patients with upper esophageal cancer, RT showed a trend toward improved survival (3-year PFS rates: 76.9% vs. 55.5%, P = 0.34; 3-year OS rates: 74.0% vs. 61.8%, P = 0.50). Among the responders after NICT (near-cCR/cPR), PFS and OS were similar between the surgery and RT groups (3-year PFS rates: 68.9% vs. 66.9%, P = 0.64; 3-year OS rates: 80.2% vs. 70.7%, P = 0.20). Regional lymph node recurrence predominated in the surgery group (50.0%), whereas locoregional esophageal recurrence was most frequent in the RT group (37.0%). The treatment-related mortality rates were 0.8% (1/117) in the surgery group and 1.7% (1/60) in the RT group, indicating the overall safety of the treatments.\n\nConclusions: Radical surgery remains the standard treatment for LA-ESCC after NICT. Definitive RT may be an organ-preserving option in selected patients, especially those with upper esophageal cancer or a favorable response to NICT.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Qiuying An"
    },
    {
      "affs": [
        0
      ],
      "name": "Yage Jia"
    },
    {
      "affs": [
        0
      ],
      "name": "Menglu Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Liyuan Fu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jingxin Bai"
    },
    {
      "affs": [
        0
      ],
      "name": "Zihan Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jin Yan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yajing Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Hongshan Ji"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuhao Su"
    },
    {
      "affs": [
        0
      ],
      "name": "Ping Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhiguo Zhou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/094nn1ge57259.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1885302",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13696280/",
  "id": "094nn1ge57259",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://doi.org/10.3389/fonc.2026.1885302",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2746|Esophageal Cancer Research and Treatment"
    ]
  ],
  "openalex": "W7221437598",
  "pdf_url": "https://europepmc.org/articles/PMC13696280?pdf=render",
  "pmcid": "PMC13696280",
  "pmid": "42935534",
  "published": "2026-10-12",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/094nn1ge57259.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:39Z",
      "native_id": "PMC13696280",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fonc.2026.1885302"
    },
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1885302",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1885302/full"
    },
    {
      "first_seen": "2026-10-30T12:22:24Z",
      "native_id": "MED:42935534",
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      "url": "https://europepmc.org/article/MED/42935534"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal Cancer Research and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Definitive radiotherapy versus surgery after neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma: a propensity score-matched study of efficacy and safety",
  "title_text": "Definitive radiotherapy versus surgery after neoadjuvant immunochemotherapy for locally advanced esophageal squamous cell carcinoma: a propensity score-matched study of efficacy and safety",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:33:38Z",
  "url": "https://research.draconitic.com/paper/094nn1ge57259",
  "venue": "Frontiers in Oncology",
  "versions": []
}