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Background <p>This research aimed to explore the significance of tumor volume change rate (TVCR) in predicting pathological response and survival prognosis for esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy.</p> Methods <p>Esophageal squamous cell carcinoma patients receiving neoadjuvant immunochemotherapy followed by esophagectomy between October 2020 and March 2024 were reviewed. The TVCR was measured and calculated through three-dimensional reconstruction based on computed tomography images. Pathological response, operative characteristics, postoperative complications were compared between the group with TVCR ≤ 45% and the group with TVCR &gt; 45% using chi-square test or independent sample t-test. The receiver operating characteristic curve and area under the curve (AUC) were employed to determine the efficacy of TVCR in predicting pathological response. The overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method with log-rank test. The univariate and multivariate Cox regression models were performed to identify the independent prognostic factors.</p> Results <p>A total of 120 esophageal squamous cell carcinoma patients receiving neoadjuvant immunochemotherapy were enrolled. The group with TVCR &gt; 45% had significantly more cases achieving major pathological response (MPR) compared to the group with TVCR ≤ 45% (49.2% vs. 27.3%, <i>P</i> = 0.014). The TVCR outperformed Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) criteria in predicting MPR (AUC, 0.614 vs. 0.574). Patients with TVCR &gt; 45% had better 3-year OS (88.7% vs. 60.7%, <i>P</i> &lt; 0.001) and DFS rates (76.8% vs. 49.8%, <i>P</i> &lt; 0.001) compared to those with TVCR ≤ 45%. Additionally, TVCR was determined as an independent prognostic factor for OS and DFS in esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy.</p> Conclusions <p>The TVCR can serve as a predictor for pathological response and survival prognosis in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy.</p>

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Tumor volume change rate based on three-dimensional reconstruction as a predictor of pathological response and survival prognosis in esophageal squamous cell carcinoma with neoadjuvant immunochemotherapy

  • 期刊论文

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  • 发表日期：

    2026年1月10日

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  • Guanzhi Ye,
  • Gaojian Pan,
  • Shengrong Lin,
  • Jie Jiang,
  • Xiaolei Zhu,
  • Guojun Geng

摘要

Background

This research aimed to explore the significance of tumor volume change rate (TVCR) in predicting pathological response and survival prognosis for esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy.

Methods

Esophageal squamous cell carcinoma patients receiving neoadjuvant immunochemotherapy followed by esophagectomy between October 2020 and March 2024 were reviewed. The TVCR was measured and calculated through three-dimensional reconstruction based on computed tomography images. Pathological response, operative characteristics, postoperative complications were compared between the group with TVCR ≤ 45% and the group with TVCR > 45% using chi-square test or independent sample t-test. The receiver operating characteristic curve and area under the curve (AUC) were employed to determine the efficacy of TVCR in predicting pathological response. The overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method with log-rank test. The univariate and multivariate Cox regression models were performed to identify the independent prognostic factors.

Results

A total of 120 esophageal squamous cell carcinoma patients receiving neoadjuvant immunochemotherapy were enrolled. The group with TVCR > 45% had significantly more cases achieving major pathological response (MPR) compared to the group with TVCR ≤ 45% (49.2% vs. 27.3%, P = 0.014). The TVCR outperformed Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) criteria in predicting MPR (AUC, 0.614 vs. 0.574). Patients with TVCR > 45% had better 3-year OS (88.7% vs. 60.7%, P < 0.001) and DFS rates (76.8% vs. 49.8%, P < 0.001) compared to those with TVCR ≤ 45%. Additionally, TVCR was determined as an independent prognostic factor for OS and DFS in esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy.

Conclusions

The TVCR can serve as a predictor for pathological response and survival prognosis in esophageal squamous cell carcinoma treated with neoadjuvant immunochemotherapy.