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Conversion surgery following immunochemotherapy for initially unresectable/recurrent esophageal cancer
Tomoki Makino1, Shigeto Nakai2, Takaomi Hagi2
1Department of Gastroenterological Surgery, Graduate School of Medicine, The University of Osaka, 2-2-E2, Yamada-oka, Suita, Osaka, 565-0871, Japan. tmakino@gesurg.med.osaka-u.ac.jp.
Esophagus : Official Journal of the Japan Esophageal Society
|December 5, 2025
Summary
Conversion surgery (CS) after immunochemotherapy is safe and feasible for unresectable or recurrent esophageal cancer. This study shows promising clinical response and R0 resection rates, though long-term outcomes need further investigation.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Conversion surgery (CS) is a potential treatment for unresectable or recurrent esophageal cancer after immunochemotherapy.
- Safety, pathological response, and oncological outcomes of CS require further definition.
Purpose of the Study:
- To assess the safety, pathological response, and oncological outcomes of conversion surgery following immunochemotherapy in esophageal cancer patients.
Main Methods:
- Retrospective analysis of 36 patients with cStage IV or recurrent esophageal cancer undergoing CS after immunochemotherapy.
- Assessment of clinical response, perioperative outcomes, pathological findings, and survival.
Main Results:
- High clinical response rate (80.6%) and R0 resection (94.4%) achieved.
- Manageable adverse events (neutropenia 55.6%) and postoperative complications (pneumonia 27.8%).
- Pathological complete response rates varied by site, with 27.6% in the primary tumor.
Conclusions:
- Conversion surgery following immunochemotherapy is feasible and safe in selected esophageal cancer patients.
- Long-term prognostic significance of CS requires further investigation.
