Prognostic Value of the C-PLAN Index in Advanced Esophageal Squamous Cell Carcinoma Patients Treated With Immune Checkpoint Inhibitors.

This study evaluated the prognostic value of the C-PLAN index in advanced esophageal squamous cell carcinoma (ESCC) patients receiving immune checkpoint inhibitor (ICI) therapy. A retrospective analysis of 241 eligible patients treated during February 2020 to January 2023 was conducted. Based on the C-PLAN index, calculated from lactate dehydrogenase (LDH), C-reactive protein (CRP), performance status (PS), albumin (ALB), and derived neutrophil-to-lymphocyte ratio (dNLR), patients were categorized into Good (0-1 points) and Poor (2-5 points) groups. The Poor group exhibited more advanced clinical stages and larger tumor diameters (both p < 0.05). The Good group demonstrated a significantly higher objective response rate and disease control rate (both p < 0.05), lower progression/death incidence (both p < 0.001), and longer progression-free survival and overall survival (p < 0.001). Multifactorial Cox regression analysis revealed that PD-L1 CPS < 10%, clinical stage IV, and high C-PLAN score (2-5 points) were independent risk factors for disease progression or death following ICI therapy in patients with advanced ESCC. The C-PLAN index effectively stratifies prognosis and optimizes therapeutic decision-making for advanced ESCC. The C-PLAN index serves as a prognostic factor, providing an objective basis for survival assessment and treatment plan optimization in advanced ESCC patients.