Esophageal squamous cell carcinoma, Anastomotic leak, Neoadjuvant, Chemoradiotherapy, Nomogram, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282

Abstract Background Anastomotic leak (AL) is a common complication in patients with operable esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) and radical esophagectomy. Therefore, this study aimed to establish and validate a nomogram to predict the occurrence of AL. Methods Between March 2016 and December 2022, ESCC patients undergoing NCRT and radical esophagectomy were retrospectively collected in China. Clinicopathologic and radiomics characteristics were included in the univariate logistic regression analysis, and statistically significant factors were enrolled to develop the nomogram, which was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA). Results 231 eligible patients were divided into training (n = 159) and validation cohorts (n = 72). Univariate and multivariate analyses revealed that dose at the anastomosis ≥ 24 Gy, gross tumor volume ≥ 60 cm3, postoperative albumin