Work

The predictive value of prognostic immune and nutritional index in esophageal squamous cell carcinoma receiving neoadjuvant immunochemotherapy: a retrospective propensity score matching study

Year: 2026

Type: article

Abstract: Background/aim: The prognostic immune and nutritional index (PINI) has been increasingly recognized as a significant parameter associated with clinical outcomes in multiple cancers. Nevertheless, its prognostic role in esophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant immunochemotherapy (NICT) remains unexplored. Methods: This retrospective research enrolled 193 ESCC treated with NICT. The threshold for PINI was determined using the restricted cubic spline (RCS) model. To control for potential confounders, propensity score matching (PSM) was applied. We subsequently assessed the correlations between PINI and both disease-free survival (DFS) and overall survival (OS). Cox proportional hazards regression models were employed to quantify these associations, with results expressed as hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Results: The RCS model established an optimal PINI cutoff at 3.320, stratifying all patients into low (n=97) and high (n=96) cohorts. To address potential confounding, PSM generated 64 balanced pairs. Patients in the low cohort demonstrated significantly worse 3-year DFS and OS compared to those with high PINI whether before (DFS: 43.3% vs. 76.0%, P<0.001; OS: 58.8% vs. 84.4%, P<0.001) or after (DFS: 48.4% vs. 68.8%, P = 0.021; OS: 64.1% vs. 81.2%, P = 0.033) PSM. Multivariate analysis confirmed PINI as an independent prognostic index for both DFS (HR = 0.423, 95% CI = 0.257-0.696, P = 0.001) and OS (HR = 0.461, 95% CI = 0.250-0.848, P = 0.013) in the pre-matched cohort. After PSM, PINI remained independently predictive of DFS (HR = 0.543, 95% CI = 0.309-0.955, P = 0.034), though not for OS. Conclusion: PINI is a significant independent parameter of prognosis, especially in DFS, in patients with ESCC receiving NICT. Incorporating PINI into existing prognostic models may improve long-term risk stratification and assist in personalizing therapeutic strategies.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1735135

Authors: Xiao Wu, Liang Wang, Xun Yang, Qixun Chen, Jifeng Feng

Institutions: Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine, Chinese Academy of Sciences

Language: English

Topic: Inflammatory Biomarkers in Disease Prognosis

Subfield: Oncology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801