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

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.