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005). Grade 3 ESCC was also significantly associated with unstable SINS (p less then 0.001). Kaplan-Meier analysis revealed that SINS was not a predictor of survival (p = 0.98). In the radiotherapy-alone group, a significant proportion of patients with potentially unstable SINS (30%) progressed into unstable SINS category at an average 364 ± 244 days (p less then 0.001). CONCLUSION This study demonstrated that more severe categories of SINS were associated with higher degrees of ESCC, and surgical interventions were more often util