ArticleJournal of inflammation research2025
Predicting Postoperative Pneumonia in ESCC After Neoadjuvant Chemo-Immunotherapy: Combined Use of ARISCAT Score and Inflammatory Biomarkers.
Article in Journal of inflammation research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
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Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Biomarkers associated with post-operative pneumonia: a systematic review and meta-analysis.BMC pulmonary medicine · 2026Pooled it
- Preoperative neutrophil-to-lymphocyte ratio and systemic immune-inflammation index as prognostic biomarkers for postoperative pneumonia and pulmonary complications after thoracic surgery: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Preoperative Fibrinogen-to-Prealbumin Ratio and in-Hospital Postoperative Pneumonia After Minimally Invasive McKeown Esophagectomy for Esophageal Squamous Cell Carcinoma: A Retrospective Cohort Study with Infection Phenotype Profiling.Infection and drug resistance · 2026Article
- Association and incremental predictive value of preoperative AISI and CALLY for postoperative pulmonary complications after McKeown esophagectomy following neoadjuvant chemoimmunotherapy.Frontiers in immunology · 2026Article
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Authors and funding
8 authors.
Funding
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Abstract
Background: Postoperative pneumonia is a common and serious complication after McKeown esophagectomy for esophageal squamous cell carcinoma (ESCC), particularly in patients receiving neoadjuvant chemo-immunotherapy. The ARISCAT score is widely used for pulmonary risk assessment in general surgery, but its predictive value in this specific oncologic setting remains unclear. Methods: We retrospectively analyzed 312 patients with resectable ESCC who underwent two cycles of platinum-based chemotherapy plus camrelizumab followed by McKeown esophagectomy between 2018 and 2023. Preoperative ARISCAT scores, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) were recorded. The primary outcome was pneumonia within 30 days postoperatively, diagnosed by standardized criteria. Logistic regression identified independent predictors, and restricted cubic splines (RCS) assessed dose-response patterns. Model discrimination and calibration were evaluated using AUC, Brier score, and calibration plots. Results: Postoperative pneumonia occurred in 86 patients (27.6%). Compared with unaffected patients, those with pneumonia had higher ARISCAT scores (53.9 vs 37.4), NLR (8.3 vs 4.9), and SII (1379.8 vs 917.2) (all p < 0.001). Multivariable analysis confirmed ARISCAT (OR 1.43, 95% CI 1.26-1.62), NLR (OR 1.66, 95% CI 1.31-2.10), and SII (OR 1.09, 95% CI 1.02-1.71) as independent predictors. RCS showed a linear association for ARISCAT (p_non-linearity = 0.794) and threshold effects for NLR (>≈5.0) and SII (>≈1300) (both p_non-linearity < 0.05). The combined model (ARISCAT + NLR + SII) demonstrated superior discrimination (AUC 0.962) and calibration (Brier score 0.152) compared with individual predictors. Conclusion: In ESCC patients undergoing McKeown esophagectomy after neoadjuvant chemo-immunotherapy, the ARISCAT score independently predicts postoperative pneumonia risk. Integrating ARISCAT with inflammatory biomarkers enhances predictive performance, enabling refined preoperative risk stratification and potentially guiding targeted preventive strategies. Prospective multicenter validation is warranted.
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