Low Cachexia Index (CXI) is a strong indicator of poorer survival in esophageal cancer patients undergoing surgery.

• Patients with low CXI had significantly worse overall survival (OS) and disease-free survival (DFS) compared to those with high CXI (both p < 0.001).
• Low CXI is also linked to older age, more severe comorbidities, and advanced tumor stage.

Consider CXI in preoperative assessments to better select patients and predict outcomes.

• Significant differences in survival by CXI were seen in both early (p < 0.045) and advanced (p < 0.001) pathological stages.