{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:59:40Z","timestamp":1780898380530,"version":"3.54.1"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Blunted nocturnal melatonin amplitude is linked to tumour-promoting inflammation in oesophageal-cancer survivors, but it is unclear whether restoring endogenous rhythms improves clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In an 18-month prospective cohort conducted in Class 3A hospitals in China and the China Urban Cancer Early Diagnosis and Treatment Project Cohort, 492 stage I\u2013III oesophageal-cancer survivors underwent salivary melatonin profiling and measurement of hs-CRP, IL-6, TNF-\u03b1 and the neutrophil-to-lymphocyte ratio. Survivors with a night-to-day melatonin ratio &amp;lt; 2.5 initiated a behavioural circadian-realignment programme; rhythm-intact peers received usual care. Linear mixed-effects and Cox models related rhythm restoration to change in composite inflammation burden\u2014calculated as the standardised mean of the four markers\u2014and to major adverse events, adjusting for demographic and clinical covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 266 rhythm-blunted survivors, 202 (76%) achieved amplitude \u2265 2.5 by 12 months. Their composite inflammation score fell by \u22120.30 \u00b1 0.18 versus \u22120.03 \u00b1 0.15 in observation participants (between-group difference \u22120.27, 95% CI \u22120.30 to \u22120.24). Significant time \u00d7 group interactions were seen for every marker (all p &amp;lt; 0.001). Over 18 months, circadian restoration was associated with a 62% lower hazard of recurrence, cardiovascular events, second primaries or death (adjusted HR 0.38, 95% CI 0.21\u20130.68). Pittsburgh Sleep Quality Index improved by \u22122.7 points relative to usual care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Behavioural realignment of endogenous melatonin rhythms was associated with sustained reductions in systemic inflammation and fewer adverse events in oesophageal-cancer survivors. Routine circadian-hygiene counselling combined with simple salivary monitoring may help support long-term oncologic and cardiometabolic health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1723531","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T05:33:08Z","timestamp":1780896788000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Restoration of melatonin rhythms reduces tumour-promoting inflammation in oesophageal cancer survivors: a prospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Tinghui","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Ningbo Yinzhou No. 2 Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, 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