2096 - Weight Loss during Neoadjuvant Chemoradiotherapy and Survival after Esophagectomy for Locally Advanced Esophageal Squamous Cell Carcinoma

03:00pm - 04:00pm ET

Poster Hall - Exhibit Hall A

Screen: 23

POSTER

Presenter(s)

Guiyu Huang, MSN, RN - Sichuan Cancer Hospital, Chengdu, Sichuan

G. Huang¹, and Q. Wang²; ¹Sichuan Cancer Hospital & Institute, Chendu, China, ²Department of Radiation Oncology, Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, Sichuan, China

Purpose/Objective(s):

Weight loss is common during neoadjuvant chemoradiotherapy (NCRT) for locally advanced esophageal squamous cell carcinoma (LA-ESCC). The prognostic relevance of its timing and longitudinal pattern in patients proceeding to esophagectomy remains uncertain.

Materials/Methods:

We retrospectively analyzed 377 patients with LA-ESCC treated with NCRT followed by curative esophagectomy between 2017 and 2023. Body weight was recorded at predefined treatment milestones from baseline through the early postoperative period. Associations between phase-specific weight loss and survival were assessed using multivariable Cox regression. Longitudinal weight-change trajectories were identified using latent class modeling.

Results:

Over a median follow-up of 60.2 months. Weight loss during NCRT independently predicted worse OS(hazard ratio[HR] 2.21, 95%CI 1.39-3.51, P=0.001) and PFS(HR 1.87, 95% CI 1.23–2.84, P=0.003). Weight loss during the interval between NCRT completion and before surgery was also associated with inferior OS(HR 2.0, 95%CI 1.18-3.4, P=0.01). In contrast, weight changes before treatment initiation or in the immediate postoperative period were not associated with survival. Patients with a low gradual decrease trajectory had significantly worse outcomes compared with those whose weight remained stable or increased(HR 2.35, 95% CI 1.4–3.95, P=0.001). Increasing magnitude of weight loss showed a linear association with mortality risk. The prognostic impact of weight loss was more pronounced in patients receiving paclitaxel–carboplatin and in those with high baseline performance status.

Conclusion:

In patients undergoing multimodality treatment for LA-ESCC, weight loss during neoadjuvant therapy identifies individuals at increased risk after esophagectomy. Serial assessment of weight trajectory may provide a simple tool for perioperative risk stratification and targeted supportive intervention.