在这项前瞻性研究中，我们旨在调查患者报告的咽喉功能改善对预测局部晚期食管鳞状细胞癌（ESCC）患者新辅助免疫化学治疗（NAIC）病理肿瘤反应的作用。本研究为多中心、前瞻性研究，包括接受NAIC治疗的ESCC患者，包括发现和验证队列。患者在多个时间点收集了欧洲肿瘤研究与治疗组织生命质量问卷OES 18和QLQ-C30的问卷答案。接下来，采用增长混合模型分析，描绘出时间点-强调食管癌特异性咽喉功能改善轨迹。此外，利用单变量和多变量二元逻辑回归分析来评估病理肿瘤反应的独立预测因素。总共有120名来自发现队列和42名来自验证队列的患者被纳入分析。在发现队列中，83名患者中有19名（22.9％）达到了pCR状态。在独立验证队列中，有24名患者接受了手术，其中9名（37.5％）患者达到了pCR状态。轨迹分析表明，在pCR组中，斜率开始急剧下降的时间点是第3、6和9天。进一步的多元分析显示，口腔异物感减轻程度（△dysphagia％）是pCR状态的唯一重要独立预测因素（OR = 3.267，95％ CI 1.66-6.428，P <0.001）。△dysphagia％的AUC值为0.961（95％ CI：0.922-0.999，P <0.001）。本研究表明，纵向的患者报告结局（PRO）是一种易于获得、经济实惠和非侵入性的预测肿瘤对新辅助免疫化学治疗反应的工具。© 2023年。外科肿瘤学协会。

In this prospective study, we aimed to investigate the role of patient-reported dysphagia relief in predicting pathological tumor responses to neoadjuvant immunochemotherapy (NAIC) in locally advanced esophageal squamous cell carcinoma (ESCC) patients.This study was designed as a multi-center, prospective study including ESCC patients who received NAIC in the discovery and validation cohorts. The patients' responses to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-OES 18 and QLQ-C30 were collected at multiple time points. Subsequent time point-intensive esophageal cancer-specific dysphagia trajectories were depicted using growth mixture modeling (GMM) analysis. Furthermore, univariate and multivariate binary logistic regression was used to assess the independent predictors for pathological tumor responses.A total of 120 patients from the discovery cohort and 42 patients from the validation cohort were included in the analysis. In the discovery cohort, 19 (22.9%) of the 83 patients achieved pCR status. In the independent validation cohort, 24 patients underwent surgery, and 9 (37.5%) patients achieved pCR status. Trajectory analysis showed that, in the pCR group, the beginning of rapid declines in the slope occurred on days 3, 6, and 9. Further multivariate analysis showed that the degree of dysphagia relief (△dysphagia%) was the only significant independent predictor for pCR status (OR = 3.267, 95% CI 1.66-6.428, P < 0.001). The AUC value for △dysphagia% was 0.961 (95% CI: 0.922-0.999, P < 0.001).The current study demonstrated that a longitudinal patient-reported outcome (PRO) was an easily obtained, cost-effective, and noninvasive tool for predicting tumor responses to neoadjuvant immunochemotherapy.© 2023. Society of Surgical Oncology.