P1.073. The Evaluative Value of Quality of Life in Neoadjuvant Treatment for Esophageal Squamous Cell Carcinoma

Abstract

Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background While neoadjuvant therapy contribute to tumor downstaging and improves resectability rates, effective tools for predicting treatment response remain limited. This study investigated quality of life before and after neoadjuvant therapy, and examined whether changes in quality of life could predict treatment response. Methods This prospective single-center study enrolled patients with esophageal squamous cell carcinoma who received neoadjuvant treatment and subsequently underwent radical esophagectomy between December 2024 and December 2025. All patients completed the EORTC QLQ-OES18 quality of life questionnaire before and after neoadjuvant treatment. The change in total quality of life score was calculated, and patients were divided into improved and non-improved groups. Differences between the two groups were analyzed with respect to pathological complete response (pCR), major pathological response (MPR), radiographic changes, and resectability. The Wilcoxon rank-sum test was used for group comparisons. Results All 33 patients demonstrated improved quality of life following neoadjuvant treatment. Improvement in obstruction was associated with post-treatment tumor length on imaging (p = 0.04) and resectability (p = 0.054). Surgically, lower pretreatment scores predicted surgical intervention (p = 0.083). Oncologically, lower post-treatment total scores were associated with pCR (p = 0.099) and MPR (p = 0.096). Fisher's exact test showed no significant association between changes in total quality of life scores and either pathological regression (pCR/MPR) or resectability. Conclusion Quality of life improved after neoadjuvant treatment in patients with esophageal squamous cell carcinoma. Improvement in obstruction symptoms was associated with resectability, suggesting its potential value in assessing surgical timing.