Development and validation of a metabolic-inflammatory-nutritional prognostic model for esophageal squamous carcinoma

The role of triglyceride-glucose (TyG) as a metabolic index in the prognosis of radical esophageal cancer remains underexplored. This study evaluated the association between TyG and postoperative prognosis in esophageal squamous cell carcinoma (ESCC) and developed a metabolic-inflammatory-nutritional (MIN) scoring model to improve prognostic assessment. This study retrospectively analyzed 434 ESCC patients who underwent radical esophagectomy, divided into development and internal validation cohorts. A MIN score was constructed using LASSO-Cox regression, and a nomogram was developed. Performance was evaluated using C-index, ROC curves, calibration, and decision curve analysis. The preoperative TyG index was an independent protective factor for overall survival (HR = 0.44, 95% CI: 0.30–0.64, P < 0.001). The MIN score showed good discriminative ability in the derivation cohort, with 1-, 3-, and 5-year AUC values of 0.749, 0.752, and 0.760, respectively, and maintained robust performance in the validation cohort (AUC: 0.747, 0.724, and 0.728). The nomogram incorporating the MIN score, age, sex, and TNM stage achieved excellent discrimination, with C-indices of 0.832 in the derivation cohort and 0.799 in the validation cohort. The preoperative TyG index is a protective prognostic factor in ESCC. The MIN score and nomogram provide a robust tool for individualized prognosis prediction, complementing TNM staging.