Prognostic Value of the PILE Score in Esophageal Squamous Cell Carcinoma Treated with Neoadjuvant Chemoradiotherapy

Background: This retrospective cohort study evaluated the role of the PILE score as a prognostic biomarker for overall survival (OS) and progression-free survival (PFS) in patients with locally advanced esophageal squamous cell carcinoma (ESCC) who were treated with neoadjuvant chemoradiotherapy (nCRT). Methods: This study included 108 patients with ESCC treated with weekly paclitaxel-carboplatin and concurrent radiotherapy at Erzurum Atat & uuml;rk University Faculty of Medicine Hospital between January 2018 and April 2024. Patients were categorized into low- (PILE score 0-1) and high-risk (PILE score 2-3) groups. Kaplan-Meier analysis and Cox regression models were used to evaluate the association between the PILE score and survival outcomes. Results: The results showed that the high-risk PILE group had significantly shorter median OS (18.6 months vs. not reached; p < 0.001) and PFS (12.4 months vs. not reached; p < 0.001) than the low-risk group. Multivariate analysis showed that the PILE risk classification [hazard ratio (HR) = 2.527; 95% confidence interval (CI): 1.380-4.629; p = 0.003] and surgical resection (HR = 0.249; 95% CI: 0.090-0.683; p = 0.007) were independent prognostic factors for OS, whereas the PILE risk classification (HR = 2.932; 95% CI: 1.525-5.639; p = 0.001) and surgical resection (HR = 0.131; 95% CI: 0.044-0.394; p < 0.001) were independent prognostic factors for PFS. Conclusions: The study concludes that the PILE score is a robust prognostic tool for OS and PFS in patients with ESCC undergoing nCRT, highlighting its potential for risk stratification and personalized treatment planning.

Journal

DIAGNOSTICS

Year

2025

Volume

15

Issue

24

eISSN

2075-4418

DOI

10.3390/diagnostics15243158

WoS UID

WOS:001648659900001