Immunotherapy in the perioperative management of esophageal squamous cell carcinoma: recent developments

Esophageal cancer ranks among the most prevalent malignancies of the gastrointestinal tract. Esophageal squamous cell carcinoma (ESCC), accounting for approximately 90% of all esophageal cancer (EC) cases, represents the dominant pathological subtype. For locally advanced ESCC at clinical stages II-IVA, surgery-based multidisciplinary treatment remains the primary management strategy. Despite concerted efforts, long-term outcomes for ESCC patients remain suboptimal. Recent years have witnessed significant advancements in immunotherapy, with PD-1/PD-L1 inhibitors demonstrating promising efficacy across various malignancies, particularly in ESCC. This review synthesizes the current landscape of perioperative immunotherapy for resectable ESCC, emphasizing the role of immune checkpoint inhibitors in the perioperative setting. Additionally, it highlights unresolved challenges in ongoing clinical research and provides insights into future directions for ESCC immunotherapy.