Brinkmann S, Noordman BJ, Hölscher AH, et al. - In this study, a pretreatment (ie prior to neoadjuvant chemoradiotherapy) pathological staging system was validated in the resection specimen after neoadjuvant chemoradiotherapy for esophageal cancer. Further, an investigation was done for the prognostic value of pretreatment pathological T and N categories (prepT and prepN categories) in both an independent and a combined patient cohort. Among patients with esophageal cancer treated with neoadjuvant chemotherapy and esophagectomy, they estimated PrepT and prepN categories based on the extent of tumor regression and regressional changes of lymph nodes in the resection specimen. The prognostic performance was assessed using the difference in Akaike’s information criterion (ΔAIC). The prepT category vs cT and ypT categories had better prognostic strength (ΔAIC 7.7 vs 3.0 and 2.9, respectively), and the prognostic strength of the prepN category vs the cN category was better and vs the ypN category was similar (ΔAIC 29.2 vs − 1.0 and 27.9, respectively). Results provide an independent confirmation of the prognostic value of prepTNM staging. PrepTNM staging is of additional prognostic value to cTNM and ypTNM. Survival was better among PrepN0/ypN0 patients than prepN +/ypN0 patients.