PD01.06. Dragon Study: Real-World Perioperative Treatment Patterns and Survival in Esophageal Squamous Cell Carcinoma Across Five High-Volume East Asian Centers

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ID: 325759
2026
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Abstract
Abstract Topic Esophageal Cancer: Adjuvant and Neo-Adjuvant Therapies Background: Esophageal squamous cell carcinoma (ESCC) remains a major health burden in East Asia. However, perioperative management varies substantially across countries and institutions. We conducted the ISDE-supported Drgon Study to characterize real-world treatment patterns in high-volume East Asian centers and explore their association with survival outcomes, providing a foundation for future risk-adjusted subgroup analyses and collaborative comparative research. Methods This multicenter retrospective cohort included consecutive ESCC patients treated between 2017 and 2022 at five tertiary high-volume centers: Sichuan Cancer Hospital (China), National Cancer Center Hospital (Japan), Samsung Medical Center (Korea), Shanghai Chest Hospital (China), and The University of Hong Kong (Hong Kong, China). Treatment strategy was categorized as surgery only, neoadjuvant therapy, adjuvant therapy, or neoadjuvant plus adjuvant therapy. Distributions were compared across centers. Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan–Meier estimates with log-rank tests. Results A total of 3,189 patients were included (Hong Kong n=165; Japan n=809; Korea n=500; Shanghai n=289; Sichuan n=1,426). Overall, neoadjuvant therapy was the most common strategy (50.0%, 1,593/3,189), followed by surgery only (36.8%, 1,175/3,189), adjuvant therapy (9.2%, 294/3,189), and neoadjuvant plus adjuvant therapy (4.0%, 127/3,189). Treatment-mode distribution differed significantly by center (P<0.001), with Japan showing predominant neoadjuvant use (80.8%), while Shanghai had the highest adjuvant (29.1%) and neoadjuvant+adjuvant (26.0%) proportions. OS status and mean OS time also differed across centers (both P<0.001). In survival analyses, OS curves differed significantly by treatment mode (log-rank P<0.0001). Conclusion Across five high-volume East Asian centers, ESCC perioperative management demonstrates marked institutional heterogeneity, with neoadjuvant therapy overall predominating but with center-specific practice signatures. OS varies significantly by treatment strategy in unadjusted analyses. These findings establish a real-world benchmark for subsequent stage- and risk-adjusted comparisons, detailed regimen-level subgroup analyses, and the design of future multicenter collaborative studies in East Asian ESCC.
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openalex_W7203883274 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Xuefeng Leng, Hiroyuki Daiko
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.076
URL
https://doi.org/10.1093/dote/doag077.076
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