{
  "abstract": "Background\n\nThis study aimed to evaluate the prognostic value of pre-treatment serum bicarbonate (HCO₃⁻) for overall survival (OS) and progression-free survival (PFS) in locally advanced esophageal squamous cell carcinoma (LA-ESCC) patients undergoing definitive radiotherapy.Methods\n\nPatients with stage Ⅱ-Ⅳa ESCC treated with definitive radiotherapy between 2015 and 2022 were screened and then divided into Group A (high HCO₃⁻) and Group B (low HCO₃⁻). Propensity score matching (PSM) was performed using sex, age, ECOG score, body mass index, tumor length, tumor location, clinical T category, clinical N category, clinical TNM stage, combined chemotherapy, and radiation dose as covariates at a 1:2 ratio (Group A: Group B). OS and PFS were compared between different groups using Kaplan-Meier analysis and Cox regression analysis.Results\n\nA total of 301 patients were included in the study. The median follow-up time was 54.1 months. The median OS and PFS were 17.3 months and 11.0 months. The median HCO₃⁻ was 24.9 mmol/L. Before PSM, the median OS was 27.0 months in Group A (HCO₃⁻ ≥26 mmol/L, n = 103) and 14.8 months in Group B (HCO₃⁻ <26 mmol/L, n = 198), p < 0.0001. The median PFS was 16.3 months in Group A and 9.6 months in Group B, p = 0.0002. After 1:2 PSM, the median OS was 25.7 months in Group A (n = 97) and 15.3 months in Group B (n = 169), p = 0.0011. The median PFS was 13.0 months in Group A and 9.6 months in Group B, p = 0.0059. Multivariate Cox analysis suggested that age ≥ 66 (HR 0.739, p = 0.036), T category < 3 (HR 0.484, p < 0.001), clinical N category < 2 (HR 0.713, p = 0.022), combined chemotherapy (HR 0.625, p = 0.003), and HCO₃⁻ ≥26 mmol/L (HR 0.656, p = 0.004) were independent favorable prognostic factors for OS. Clinical T category < 3 (HR 0.565, p < 0.001), clinical stage Ⅱ-Ⅲ (HR 0.685, p = 0.019), and pre-treatment HCO₃⁻ ≥26 mmol/L (HR 0.717, p = 0.019) were independent favorable prognostic factors for PFS.Conclusions\n\nA high pre-treatment serum bicarbonate level is associated with an increased OS and PFS in LA-ESCC patients undergoing definitive radiotherapy. Therefore, pre-treatment serum bicarbonate may serve as a readily available prognostic biomarker to inform risk stratification and treatment planning in LA-ESCC patients undergoing definitive radiotherapy.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, NO.12, Jiankang Road, Shijiazhuang, China.",
    "Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, NO.12, Jiankang Road, Shijiazhuang, China. 47700723@hebmu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hongshan Ji"
    },
    {
      "affs": [
        0
      ],
      "name": "Ping Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yajing Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yuhao Su"
    },
    {
      "affs": [
        0
      ],
      "name": "Hanyu Si"
    },
    {
      "affs": [
        0
      ],
      "name": "Yage Jia"
    },
    {
      "affs": [
        0
      ],
      "name": "Xueying Qiao"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhiguo Zhou"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4wte0xmnr6c93.bib",
  "cited_by": 0,
  "doi": "10.1186/s12885-026-16723-7",
  "fulltext_url": "https://europepmc.org/articles/PMC13753426",
  "id": "4wte0xmnr6c93",
  "issns": [
    "1471-2407"
  ],
  "landing_url": "https://europepmc.org/article/MED/43009855",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Esophageal Cancer Research and Treatment"
    ]
  ],
  "openalex": "W7202370593",
  "pdf_url": "https://europepmc.org/articles/PMC13753426?pdf=render",
  "pmcid": "PMC13753426",
  "pmid": "43009855",
  "published": "2026-08-14",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4wte0xmnr6c93.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T15:22:43Z",
      "native_id": "MED:43009855",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/43009855"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal Cancer Research and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Pre-treatment serum bicarbonate predicts survival in patients with locally advanced esophageal squamous cell carcinoma undergoing definitive radiotherapy: a retrospective propensity score matching study.",
  "title_text": "Pre-treatment serum bicarbonate predicts survival in patients with locally advanced esophageal squamous cell carcinoma undergoing definitive radiotherapy: a retrospective propensity score matching study.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T03:20:44Z",
  "url": "https://research.draconitic.com/paper/4wte0xmnr6c93",
  "venue": "BMC cancer",
  "versions": []
}