PD07.09. Neoadjuvant Immuno-Chemotherapy as an Initial Treatment Strategy for Esophageal Squamous Cell Carcinoma With Synchronous Primary Cancers in Pharynx and Larynx

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Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background Esophageal squamous cell carcinoma (ESCC) with synchronous primary cancers in pharynx and larynx (SPC-PL) is rare and lacks standard-of-care treatment. This study examined tumor response and survival after neoadjuvant immuno-chemotherapy (nICT) in ESCC patients with SPC-PL. Methods This retrospective single-center study analyzed 21 patients with ESCC and SPC-PL who received nICT between 2020 and 2024. Treatment response was evaluated using clinical (endoscopic and radiological) and pathological criteria. Outcomes included response rates, overall survival (OS), and progression-free survival (PFS) and laryngeal preservation rates. Results The nICT regimen induced a clinical complete response (CR) in 71.4% (15/21) of SPC-PL lesions and a pathological CR in 38.5% (5/13) of resected esophageal specimens. With a median follow-up of 28.2 months, the 2-year OS and PFS rates were 75.9% and 44.1%, respectively. Laryngeal-preserving strategies were successfully implemented in 85.7% (6/7) of patients with locally advanced SPC-PL (cT2-3N0-2) who were conventional candidates for total laryngo-pharyngectomy. No significant difference in OS or PFS was observed compared to a concurrent surgical resection cohort (n=18). Conclusion nICT showed promising efficacy in treating ESCC patients with SPC-PL, providing high rates of tumor regression and laryngeal preservation. These results support nICT as an initial treatment option for ESCC patients with SPC-PL but further validation is needed.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.