Prognostic value of tertiary lymphoid structures in locally advanced esophageal squamous cell carcinoma treated with neoadjuvant chemoimmunotherapy: a retrospective study.

Authors

Tiantian Xue, Yuhao Wu, Qihan Zi, Tiancui Zi, Shengguai Gao, Jie Mao, Yizhou Peng, Jiaping Chen, Xi Wang

Published in

Journal of cardiothoracic surgery. Jun 21, 2026. Epub Jun 21, 2026.

Abstract

This retrospective study analyzed 73 patients with locally advanced esophageal squamous cell carcinoma (ESCC) who received neoadjuvant chemoimmunotherapy, aiming to investigate the impact of the multiple heterogeneity of tertiary lymphoid structures (TLS) on treatment efficacy and prognosis. The results demonstrated that intratumoral TLS presence correlated with superior radiological and pathological responses, whereas peritumoral TLS expression was associated with poorer outcomes. Regarding spatial heterogeneity, the subgroup characterized by high intratumoral TLS abundance combined with absent peritumoral TLS exhibited the most favorable progression-free survival (PFS) and overall survival (OS). Furthermore, a higher degree of TLS maturation was significantly associated with improved survival benefits. Multivariate analysis confirmed that body mass index (BMI) served as an independent protective factor for both PFS and OS, while pre-treatment TNM stage emerged as an independent risk factor for PFS. These findings suggest that TLS holds promise as a potential predictive biomarker for the efficacy of neoadjuvant chemoimmunotherapy.

PMID:
42324542
Bibliographic data and abstract were imported from PubMed on 22 Jun 2026.

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