{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:35:32Z","timestamp":1786977332018,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018625","name":"Science and Technology Innovation Plan Of Shanghai Science and Technology Commission","doi-asserted-by":"publisher","award":["22Y11907200"],"award-info":[{"award-number":["22Y11907200"]}],"id":[{"id":"10.13039\/501100018625","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81400681"],"award-info":[{"award-number":["81400681"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2018M631394"],"award-info":[{"award-number":["2018M631394"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In esophageal cancer, the ypN0 status after induction therapy could be categorized into two primary groups: \u201cnatural N0\u201d (cN0\/ypN0) and \u201cdown\u2010staged N0\u201d (cN+\/ypN0). The assessment of cN status is typically based on clinical imagination or pathological regression. However, there is no standardized method for evaluating cN\/ypN status. This study aims to investigate the prognosis of patients with cN+\/ypN0 using both assessment methods through a cohort study and meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospectively maintained database encompassing esophageal cancer patients undergoing induction therapy followed by radical esophagectomy was comprehensively reviewed. The prognostic significance of cN+\/ypN0 across two evaluation methods was quantified. Additionally, a meta\u2010analysis using data from previous studies was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      578 patients were identified from the cohort analysis, with 342 classified as ypN0 and 236 as ypN+. When evaluated with clinical imagination, patients with cN+\/ypN0 had survival outcomes comparable to those with natural N0 but significantly better than those with ypN+ (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Using pathological nodal regression, cN+\/ypN0 patients showed superior overall survival compared to ypN+ patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0043), although their disease\u2010free survival was notably inferior to that of natural N0 patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0088). A meta\u2010analysis of 20 previous studies confirmed the prognostic value of cN+\/ypN0 status in both clinical imagination and pathological regression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For esophageal cancer patients receiving neoadjuvant, cN+\/ypN0 status, assessed through both clinical imagination and pathological regression, serves as a significant prognostic factor. It holds precedence over ypN+ yet falls short of the natural N0. The pre\u2010treatment categorizations warrant recognition as a novel and pertinent staging metric.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70664","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T08:00:46Z","timestamp":1738915246000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Nodal Downstaging of Esophageal Cancer After Neoadjuvant Therapy: A Cohort Study and Meta\u2010Analysis"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7469-5499","authenticated-orcid":false,"given":"Feng","family":"Su","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1017-4197","authenticated-orcid":false,"given":"Xu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaxing","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Zhongshan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.79.1483"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.0597"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21399"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12538"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5736-8"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-019-04317-7"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2021.04.026"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10900"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-018-0641-9"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-018-0642-8"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-020-00777-y"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003445"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.09.074"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2005.00521.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06310-9"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.15473"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004238"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cjp2.169"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.07.037"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2016.04.003"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27065"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-020-05481-7"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-016-5440-8"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-08024-0"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-09363-z"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001630"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182a66588"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2017.06.007"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doab021"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1586\/era.10.150"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.21037\/tgh.2017.01.08"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-966233"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604200"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.03.081"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2007.01.023"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyt061"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.10.508"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.70664","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T08:01:46Z","timestamp":1750924906000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.70664"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1002\/cam4.70664"],"URL":"https:\/\/doi.org\/10.1002\/cam4.70664","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70664"}}