For patients with resectable oesophageal squamous cell carcinoma, neoadjuvant chemotherapy offers significantly better survival outcomes than chemoradiotherapy after achieving a pathological complete response.

• Among patients achieving complete response, 5-year overall survival was 97.5% with chemotherapy vs. 70.4% with chemoradiotherapy.
• Recurrence-free survival also favored chemotherapy (80.8% vs. 63.7%).

Consideration of watch-and-wait strategies may be warranted for patients responding well to chemotherapy.

• R0 resection rates were similar but pCR rates favored chemoradiotherapy (34.2% vs. 6.9%).