{
  "abstract": "Lymph nodes (LNs), principal sites of antitumor immunity, may undergo immune-mediated regression; whether neoadjuvant chemoimmunotherapy (NCIT)-induced regression indicates prognosis in esophageal squamous cell carcinoma (ESCC) remains unclear. We aimed to establish and validate a lymph node regression grade (LNRG) system for prognostic stratification. This multicenter, retrospective cohort study analyzed 965 patients receiving PD-1-based NCIT and surgery at three Chinese tertiary cancer centers. LNRG was the ratio of summed viable tumor area to summed bed area (residual viable plus regressed preexisting tumor) across all dissected LNs. Negative LNs were assigned LNRG 0. Survival and predictive performance were assessed using Kaplan-Meier/Cox regression, time-dependent area under the curve, Brier score, net reclassification improvement, and integrated discrimination improvement. Overall, 28,882 LNs were evaluated; patients were classified as LNRG 0-4 in 385 (39.9%), 150 (15.5%), 26 (2.7%), 141 (14.6%), and 263 (27.3%), respectively. LNRG independently predicted disease-free and overall survival, with Grades 1-2 conferring the most favorable outcomes and Grade 4 the poorest. A random survival forest model incorporating LNRG, tumor regression grade, ypAJCC stage, and perineural invasion predicted 2-year disease-free survival in training and external validation cohorts. LNRG is a novel, independent prognostic indicator after NCIT.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center for Cancer State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine Key Laboratory of Cancer Prevention and Therapy Tianjin's Clinical Research Center for Cancer Tianjin China.",
    "Department of Radiotherapy The Fourth Hospital of Hebei Medical University Shijiazhuang China.",
    "Department of Radiotherapy Shanxi Province Cancer Hospital Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences Cancer Hospital Affiliated to Shanxi Medical University Taiyuan China.",
    "Department of Pathology Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital Chinese Academy of Medical Sciences Cancer Hospital Affiliated to Shanxi Medical University Taiyuan China.",
    "Department of Esophageal Surgery Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center of Cancer Key Laboratory of Cancer Prevention and Therapy of Tianjin Tianjin's Clinical Research Center for Cancer Hexi Tianjin China.",
    "Department of Minimally Invasive Esophageal Surgery Tianjin Medical University Cancer Hospital and Institute National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin China.",
    "Department of Pathology Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin's Clinical Research Center for Cancer Tianjin China.",
    "Department of Immunology Tianjin Medical University Cancer Institute & Hospital National Clinical Research Center for Cancer State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine Key Laboratory of Cancer Immunology and Biotherapy Tianjin's Clinical Research Center for Cancer Tianjin China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jian Zheng"
    },
    {
      "affs": [
        1
      ],
      "name": "Wenbin Shen"
    },
    {
      "affs": [
        2
      ],
      "name": "Jianzhong Cao"
    },
    {
      "affs": [
        0
      ],
      "name": "Linrui Gao",
      "orcid": "0000-0003-2730-7910"
    },
    {
      "affs": [
        3
      ],
      "name": "Likun Zan"
    },
    {
      "affs": [
        0
      ],
      "name": "Tian Zhang"
    },
    {
      "affs": [
        4
      ],
      "name": "Lei Gong"
    },
    {
      "affs": [
        5
      ],
      "name": "Xiaofeng Duan"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaobin Wang"
    },
    {
      "affs": [
        3
      ],
      "name": "Yueqin Wu"
    },
    {
      "affs": [
        4
      ],
      "name": "Peng Tang"
    },
    {
      "affs": [
        5
      ],
      "name": "Hongjing Jiang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qingsong Pang"
    },
    {
      "affs": [
        6
      ],
      "name": "Gang Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Wencheng Zhang"
    },
    {
      "affs": [
        7
      ],
      "name": "Cihui Yan",
      "orcid": "0000-0002-9391-0403"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dg4jg8re0qcvq.bib",
  "cited_by": 0,
  "doi": "10.1002/mco2.71075",
  "fulltext_url": "https://europepmc.org/articles/PMC13686415",
  "id": "dg4jg8re0qcvq",
  "issns": [
    "2688-2663"
  ],
  "landing_url": "https://europepmc.org/article/MED/42910074",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Esophageal Cancer Research and Treatment"
    ]
  ],
  "openalex": "W7223157552",
  "pdf_url": "https://europepmc.org/articles/PMC13686415?pdf=render",
  "pmcid": "PMC13686415",
  "pmid": "42910074",
  "published": "2026-10-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dg4jg8re0qcvq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42910074",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42910074"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Esophageal Cancer Research and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Lymph Node Regression Improves Prognostic Stratification in Esophageal Squamous Cell Carcinoma Receiving Neoadjuvant Chemoimmunotherapy: A Multicenter Retrospective Cohort Study.",
  "title_text": "Lymph Node Regression Improves Prognostic Stratification in Esophageal Squamous Cell Carcinoma Receiving Neoadjuvant Chemoimmunotherapy: A Multicenter Retrospective Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/dg4jg8re0qcvq",
  "venue": "MedComm",
  "versions": []
}