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<p>Pathologic complete response (pCR; ypT0N0) after neoadjuvant therapy (NAT) is a robust surrogate of superior outcomes in esophageal cancer. Pragmatic pre-treatment predictors are needed to inform clinical decision-making across diverse settings. We retrospectively analyzed 187 consecutive patients who underwent esophagectomy after NAT (2019–2025). A prespecified four-variable multivariable logistic regression model incorporated pre-treatment factors: NAT type, clinical nodal status, histology, and body mass index (BMI). A bedside nomogram was constructed and internally validated. Survival outcomes were stratified by pCR. The pCR rate was 27.3%. On multivariable analysis, independent predictors of pCR were neoadjuvant chemoradiotherapy (aOR 20.07; 95% CI [4.02–64.7]), clinical nodal negativity (aOR for nodal positivity 0.04; 95% CI [0.007–0.19]), higher BMI (Overweight aOR 2.46; 95% CI [0.70–8.65]), and squamous cell histology (aOR for adenocarcinoma 0.36; 95% CI [0.17–1.36]). Achieving pCR significantly improved two-year recurrence-free survival (75% vs. 47%; <i>p</i> = 0.003) and two-year overall survival (89% vs. 74%; <i>p</i> = 0.07). Treatment intensity, nodal burden, nutritional status, and histology significantly influence the likelihood of pCR. A simple four-factor nomogram provides individualized risk estimates and may support multidisciplinary planning and prehabilitation strategies.</p>

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Predictors of Pathologic Complete Response after Neoadjuvant Therapy in Esophageal Cancer: a Parsimonious Model and Nomogram from a High-Volume Indian Center

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Mayank Tripathi,
  • Reshma R. Balachandran,
  • Vaibhav Kushwaha,
  • Ankita Pal,
  • Paramita Paul,
  • Dhaval Vadodaria,
  • Akhil Kapoor,
  • Ajay Choubey,
  • Arvind Suresh,
  • Satyajit Pradhan

摘要

Pathologic complete response (pCR; ypT0N0) after neoadjuvant therapy (NAT) is a robust surrogate of superior outcomes in esophageal cancer. Pragmatic pre-treatment predictors are needed to inform clinical decision-making across diverse settings. We retrospectively analyzed 187 consecutive patients who underwent esophagectomy after NAT (2019–2025). A prespecified four-variable multivariable logistic regression model incorporated pre-treatment factors: NAT type, clinical nodal status, histology, and body mass index (BMI). A bedside nomogram was constructed and internally validated. Survival outcomes were stratified by pCR. The pCR rate was 27.3%. On multivariable analysis, independent predictors of pCR were neoadjuvant chemoradiotherapy (aOR 20.07; 95% CI [4.02–64.7]), clinical nodal negativity (aOR for nodal positivity 0.04; 95% CI [0.007–0.19]), higher BMI (Overweight aOR 2.46; 95% CI [0.70–8.65]), and squamous cell histology (aOR for adenocarcinoma 0.36; 95% CI [0.17–1.36]). Achieving pCR significantly improved two-year recurrence-free survival (75% vs. 47%; p = 0.003) and two-year overall survival (89% vs. 74%; p = 0.07). Treatment intensity, nodal burden, nutritional status, and histology significantly influence the likelihood of pCR. A simple four-factor nomogram provides individualized risk estimates and may support multidisciplinary planning and prehabilitation strategies.