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<p>The purpose of this study was to explore the feasibility of predicting the main pathologic response (MPR) after neoadjuvant therapy (NAT) for locally advanced esophageal squamous cell carcinoma (LAESCC) using computed tomography (CT) imaging. From January 2022 to December 2023, a retrospective study was conducted on 150 patients who underwent neoadjuvant therapy and radical resection of R0 esophageal cancer in our hospital. Before and after neoadjuvant therapy, the tumour volume (TV) was manually delineated using an enhanced CT image background processor combined with MIMINICS reconstruction software, and the tumour volume regression rate (TVRR) was calculated. Binary logistic regression was used to analyse the factors influencing the postoperative pathological MPR using univariate and multivariate analyses. Determine the predictive value of TVRR through the receiver operating characteristic curve. The mean baseline tumor volume regression ratio was 42.8% (± 22.0). Multivariate analysis revealed that the neoadjuvant therapy mode, tumour volume after neoadjuvant therapy (TV after NAT) and TVRR were independent factors affecting the postoperative pathological MPR. According to the receiver operating characteristic (ROC) analysis, the TVRR showed good predictive value for the postoperative pathological MPR (AUC = 0.828, sensitivity = 85.7%, specificity = 71.2%, <i>p</i> &lt; 0.001), and the cut-off value determined by the Youden index was 42.61%. Subgroup analysis indicated that TVRR had good predictive efficacy for postoperative pathological MPR in different neoadjuvant treatment modes and various tumour locations in the thoracic segment. The TVRR before and after neoadjuvant therapy for esophageal squamous cell carcinoma is an independent factor influencing the postoperative pathological MPR and has good predictive efficacy.</p>

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CT imaging is a feasible method for the preoperative prediction of the main pathologic response after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma

  • 期刊论文

  • 发表日期：

    2026年3月13日

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  • Hang Zhou,
  • Wen-Wei Wei,
  • Jun-Peng Lin,
  • Peng-Qiang Gao,
  • Hao He,
  • Shuo-Yan Liu,
  • Feng Wang

摘要

The purpose of this study was to explore the feasibility of predicting the main pathologic response (MPR) after neoadjuvant therapy (NAT) for locally advanced esophageal squamous cell carcinoma (LAESCC) using computed tomography (CT) imaging. From January 2022 to December 2023, a retrospective study was conducted on 150 patients who underwent neoadjuvant therapy and radical resection of R0 esophageal cancer in our hospital. Before and after neoadjuvant therapy, the tumour volume (TV) was manually delineated using an enhanced CT image background processor combined with MIMINICS reconstruction software, and the tumour volume regression rate (TVRR) was calculated. Binary logistic regression was used to analyse the factors influencing the postoperative pathological MPR using univariate and multivariate analyses. Determine the predictive value of TVRR through the receiver operating characteristic curve. The mean baseline tumor volume regression ratio was 42.8% (± 22.0). Multivariate analysis revealed that the neoadjuvant therapy mode, tumour volume after neoadjuvant therapy (TV after NAT) and TVRR were independent factors affecting the postoperative pathological MPR. According to the receiver operating characteristic (ROC) analysis, the TVRR showed good predictive value for the postoperative pathological MPR (AUC = 0.828, sensitivity = 85.7%, specificity = 71.2%, p < 0.001), and the cut-off value determined by the Youden index was 42.61%. Subgroup analysis indicated that TVRR had good predictive efficacy for postoperative pathological MPR in different neoadjuvant treatment modes and various tumour locations in the thoracic segment. The TVRR before and after neoadjuvant therapy for esophageal squamous cell carcinoma is an independent factor influencing the postoperative pathological MPR and has good predictive efficacy.