Post-treatment triglyceride-glucose index as survival protective factors in patients with esophageal squamous cell carcinoma

doi:10.5306/wjco.v17.i1.113304

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World Journal of Clinical Oncology

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2218-4333

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Oncol. Jan 24, 2026; 17(1): 113304
Published online Jan 24, 2026. doi: 10.5306/wjco.v17.i1.113304

Post-treatment triglyceride-glucose index as survival protective factors in patients with esophageal squamous cell carcinoma

Ling Xiao, Yu-Di Liu, Xue Zhang, Shi-Chuan Zhang, Jia-Hua Lyu

Ling Xiao, Yu-Di Liu, Xue Zhang, Shi-Chuan Zhang, Jia-Hua Lyu, Department of Radiation, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, China

Co-first authors: Ling Xiao and Yu-Di Liu.

Co-corresponding authors: Shi-Chuan Zhang and Jia-Hua Lyu.

Author contributions: Xiao L handled conceptualization, project administration, resources, and supervision; Xiao L and Liu YD managed data curation, and visualization, they contributed equally to this article, they are the co-first authors of this manuscript; Zhang X oversaw software; Xiao L, Liu YD, and Zhang SC took charge of methodology; Lyu JH handled funding acquisition; Xiao L, Liu YD, Zhang X, Zhang SC, and Lyu JH contributed to investigation, validation, writing original draft, and writing review and editing; Zhang SC and Lyu JH contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Sichuan Cancer Hospital’s Medical Ethics Committee, No. SCCHEC2015010.

Informed consent statement: The informed consent was waived by the Institutional Review Board.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Jia-Hua Lyu, PhD, Associate Chief Physician, Senior Researcher, Department of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, No. 55 Section 4, Renmin South Road, Chengdu 610041, Sichuan Province, China. winlttljh@163.com

Received: August 22, 2025
Revised: September 16, 2025
Accepted: December 1, 2025
Published online: January 24, 2026
Processing time: 151 Days and 16.7 Hours

Abstract

BACKGROUND

Patients with esophageal cancer exhibit marked variability in prognosis, highlighting the need for metabolism-related biomarkers. Although metabolic reprogramming is considered to be correlated with the prognosis of patients with esophageal squamous cell carcinoma (ESCC), its specific association mechanisms remain unclear.

AIM

To explore the triglyceride-glucose (TyG) index and its derivatives - indicators for insulin resistance, a core feature of metabolic syndrome. Given their controversial associations with cancer and limited research on their dynamic changes in ESCC patients post-treatment, this study aims to analyze these dynamic changes.

METHODS

The present retrospective study analyzed 360 East Asian patients with ESCC who received definitive chemoradiotherapy to explore the associations of TyG, TyG-body weight, and TyG-body mass index (both pre- and post-treatment) with overall survival.

RESULTS

Elevated levels of post-treatment TyG and its derivatives (postTyG, postTyG-body weight, postTyG-body mass index) were significantly associated with a reduced risk of death, showing a superior prognostic value compared to the baseline levels (preTyG). Restricted cubic spline analysis confirmed the presence of non-linear or monotonic associations, with more pronounced correlations observed in male patients.

CONCLUSION

Post-treatment TyG and its derivatives may serve as independent prognostic indicators for East Asian patients with ESCC, providing a basis for personalized diagnosis and treatment.

Keywords: Esophageal squamous cell carcinoma; Chemoradiotherapy; Insulin resistance; Triglyceride-glucose index; Metabolic syndrome

Core Tip: This study shows post-treatment triglyceride-glucose (TyG) index and its derivatives (TyG-body weight, TyG-body mass index) correlate with lower death risk in East Asian esophageal squamous cell carcinoma patients after definitive chemoradiotherapy, outperforming pre-treatment levels (especially in males) and acting as independent prognostic indicators, which may guide prognosis stratification, treatment monitoring, offer novel insights into personalized management, and serve as a robust basis for clinical decision optimization.