Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma
PurposeTo develop a prognosis nomogram for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients after neoadjuvant immunochemotherapy (NICT) and assess postoperative adjuvant therapy (PAT) value through survival risk stratification.MethodsWe retrospectively analyzed 297 LA-ESCC pati...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1621607/full |
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| author | Qiuying An Hongyan Wang Hui Zhu Yage Jia Yibing Liu Zheng Liu Jin Yan Zihan Zhang Yajing Wang Ping Zhang Zhiguo Zhou |
| author_facet | Qiuying An Hongyan Wang Hui Zhu Yage Jia Yibing Liu Zheng Liu Jin Yan Zihan Zhang Yajing Wang Ping Zhang Zhiguo Zhou |
| author_sort | Qiuying An |
| collection | DOAJ |
| description | PurposeTo develop a prognosis nomogram for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients after neoadjuvant immunochemotherapy (NICT) and assess postoperative adjuvant therapy (PAT) value through survival risk stratification.MethodsWe retrospectively analyzed 297 LA-ESCC patients (2019–2023) receiving NICT with or without PAT, randomly divided into the training and validation cohorts. Independent prognostic factors were determined by Least Absolute Shrinkage and Selection Operator (Lasso) regression and multivariate Cox analysis. Progression-free survival (PFS) was compared by the Kaplan-Meier analysis.ResultsThe median follow-up time after surgery was 31.67 months (2.23-62.5 months) as of January 25, 2025. The 1-year and 2-year PFS rates were 82.8% and 67.8%. The analysis identified tumor length, tumor thickness reduction rate, surgical method, number of lymph nodes dissected, and ypN-stage as independent prognostic factors. In the training and validation cohorts, the Concordance Index (C-index) of the nomogram was 0.776 and 0.818. The area under the curve (AUC) values for predicting 1-year PFS were 0.823 and 0.899, while the AUC values for predicting 2-year PFS were 0.802 and 0.810, respectively. According to the nomogram, patients were divided into three risk groups (low, medium, and high), and there were significant differences in PFS among the groups (P<0.001). Survival analysis showed that PAT significantly improved PFS in the high-risk group (1-year: 53.3% vs. 26.7%; 2-year: 35.6% vs. 6.7%, P=0.009), but there was no significant difference in the low and medium risk groups.ConclusionThe prognosis nomogram can effectively predict the PFS of LA-ESCC patients after NICT. Through survival risk stratification, patients in the high-risk group may benefit from PAT. |
| format | Article |
| id | doaj-art-c8d9a45ee2bd46808926c68ad76cdcfb |
| institution | DOAJ |
| issn | 1664-3224 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-c8d9a45ee2bd46808926c68ad76cdcfb2025-08-20T02:48:54ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16216071621607Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinomaQiuying An0Hongyan Wang1Hui Zhu2Yage Jia3Yibing Liu4Zheng Liu5Jin Yan6Zihan Zhang7Yajing Wang8Ping Zhang9Zhiguo Zhou10Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Medical Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Oncology, Handan Central Hospital, Handan, Hebei, ChinaDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaDepartment of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, ChinaPurposeTo develop a prognosis nomogram for locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients after neoadjuvant immunochemotherapy (NICT) and assess postoperative adjuvant therapy (PAT) value through survival risk stratification.MethodsWe retrospectively analyzed 297 LA-ESCC patients (2019–2023) receiving NICT with or without PAT, randomly divided into the training and validation cohorts. Independent prognostic factors were determined by Least Absolute Shrinkage and Selection Operator (Lasso) regression and multivariate Cox analysis. Progression-free survival (PFS) was compared by the Kaplan-Meier analysis.ResultsThe median follow-up time after surgery was 31.67 months (2.23-62.5 months) as of January 25, 2025. The 1-year and 2-year PFS rates were 82.8% and 67.8%. The analysis identified tumor length, tumor thickness reduction rate, surgical method, number of lymph nodes dissected, and ypN-stage as independent prognostic factors. In the training and validation cohorts, the Concordance Index (C-index) of the nomogram was 0.776 and 0.818. The area under the curve (AUC) values for predicting 1-year PFS were 0.823 and 0.899, while the AUC values for predicting 2-year PFS were 0.802 and 0.810, respectively. According to the nomogram, patients were divided into three risk groups (low, medium, and high), and there were significant differences in PFS among the groups (P<0.001). Survival analysis showed that PAT significantly improved PFS in the high-risk group (1-year: 53.3% vs. 26.7%; 2-year: 35.6% vs. 6.7%, P=0.009), but there was no significant difference in the low and medium risk groups.ConclusionThe prognosis nomogram can effectively predict the PFS of LA-ESCC patients after NICT. Through survival risk stratification, patients in the high-risk group may benefit from PAT.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1621607/fulllocally advanced esophageal squamous carcinomaneoadjuvant immunochemotherapyprognosisnomogramrisk stratificationpostoperative adjuvant therapy |
| spellingShingle | Qiuying An Hongyan Wang Hui Zhu Yage Jia Yibing Liu Zheng Liu Jin Yan Zihan Zhang Yajing Wang Ping Zhang Zhiguo Zhou Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma Frontiers in Immunology locally advanced esophageal squamous carcinoma neoadjuvant immunochemotherapy prognosis nomogram risk stratification postoperative adjuvant therapy |
| title | Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma |
| title_full | Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma |
| title_fullStr | Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma |
| title_full_unstemmed | Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma |
| title_short | Nomogram-based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma |
| title_sort | nomogram based risk stratification to analyze the value of receiving postoperative adjuvant therapy after neoadjuvant immunochemotherapy for patients with locally advanced esophageal squamous carcinoma |
| topic | locally advanced esophageal squamous carcinoma neoadjuvant immunochemotherapy prognosis nomogram risk stratification postoperative adjuvant therapy |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1621607/full |
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