Predicting Anastomotic Leak After Neoadjuvant Chemoimmunotherapy and Esophagectomy: A Dynamic Inflammatory and Nutritional Biomarker Model.
Dynamic biomarker model predicts anastomotic leak after esophagectomy with good accuracy
Predicting Anastomotic Leak After Neoadjuvant Chemoimmunotherapy and Esophagectomy: A Dynamic Inflammatory and Nutritional Biomarker Model.
To determine the incidence of anastomotic leak (anastomotic leak) following esophagectomy after neoadjuvant immunochemotherapy (neoadjuvant immunochemotherapy) for esophageal squamous cell carcinoma (esophageal squamous cell carcinoma) and to develop a novel prediction model integrating dynamic inflammatory and nutritional biomarkers.
This two-center, retrospective study enrolled 550 patients (350 in training cohort, 200 in external validation cohort) with locally advanced esophageal squamous cell carcinoma who underwent neoadjuvant immunochemotherapy followed by esophagectomy.
model correctly distinguishes leak from no-leak cases most of the time, 1.0 would be perfect
The incidence of anastomotic leak was 10.57% (training) and 11.50% (validation).
Most leaks were cervical (93.33%), of Grade II/III severity (78.33%), and nearly half led to anastomotic stenosis (46.67%).
The final prediction model incorporated ΔNPR_cat, ΔPAR_cat, ΔHALP_cat and two clinical variables (BMI < 18.5 kg/m 2 , ECOG performance status ≥ 1).
Calibration plots showed good agreement between predicted and observed probabilities.
Anastomotic leak remains a significant complication after neoadjuvant immunochemotherapy and esophagectomy. We established and validated a practical prediction model that dynamically integrates biomarker trajectories and clinical factors.
This tool may help identify high-risk patients preoperatively and thereby support the implementation of tailored perioperative strategies, such as intensified monitoring, proactive nutritional support, or selective anastomotic protection measures.