AB122. SOH25_AB_280. The contemporary management of locally advanced oesophageal squamous cell cancer in the era of definitive chemoradiotherapy: a systematic review
Systematic Reviews Session

AB122. SOH25_AB_280. The contemporary management of locally advanced oesophageal squamous cell cancer in the era of definitive chemoradiotherapy: a systematic review

Kaotharat Balogun1, Matthew Davey2, Raha Javadi Esfahani3, Noel Donlon3

1Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland; 2Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 3Department of Surgery, St. James’s Hospital, Dublin, Ireland

Background: Despite novel multimodal therapies, the optimal treatment approach for oesophageal squamous cell carcinoma (OSCC) remains controversial. This systematic review aims to compare definitive chemoradiotherapy (dCRT), neoadjuvant chemotherapy followed by surgery (NACT+S), and neoadjuvant chemoradiotherapy plus surgery (NACRT+S) on oncological and survival outcomes in patients with resectable OSCC.

Methods: A systematic review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Descriptive statistics were performed using SPSS v26.0.

Results: Overall, nine studies with a total of 1,880 patients were included. In total, 641 patients received dCRT (34.1%), 648 underwent NACT+S (34.5%), and 591 underwent NACRT+S (31.4%). Overall, the resection rates were similar between NACT+S at 93.6% (427/456) and NACRT+S at 93.5% (300/321) (P=1.000). NACT+S had the highest 1-year overall survival (OS) at 90.2% (238/264), followed by NACRT+S 83.9% (78/93) and dCRT 80.4% (205/255) (P=0.007). Locoregional recurrence rates were 19.6% for NACRT+S (104/531), 21.9% for NACT+S (96/439), and 30.7% for dCRT (151/492) (P<0.001). NACRT+S had the highest 5-year OS at 48.0% (147/306), dCRT 44.0% (216/491), and NACT+S 40.7% (169/415) (P=0.147).

Conclusions: While NACT+S demonstrated higher 1-year OS rates for OSCC, there were no significant differences in margin free (R0) resection rates or 5-year OS outcomes between NACT+S and NACRT+S. Locoregional recurrence rates were lower with both NACRT+S and NACT+S compared to dCRT, suggesting potential oncological benefits in disease control, while dCRT remains a practical alternative for select cases. These findings may be utilised to guide and personalise future multidisciplinary team decision making for patients diagnosed with resectable OSCC.

Keywords: Oesophageal squamous cell carcinoma (OSCC); chemoradiotherapy; chemotherapy; surgery; survival outcomes

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab122
Cite this abstract as: Balogun K, Davey M, Esfahani RJ, Donlon N. AB122. SOH25_AB_280. The contemporary management of locally advanced oesophageal squamous cell cancer in the era of definitive chemoradiotherapy: a systematic review. Mesentery Peritoneum 2025;9:AB122.

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