ReCAST: Single-Cell-Informed Tumour Microenvironment Profiling for Translational Prognostic Assessment in Esophageal Cancer

Background/Objectives: Single-cell transcriptomics provides detailed maps of the tumour microenvironment, but translating these maps to large clinical cohorts requires methods that can recover biologically meaningful cell states from routinely available bulk transcriptomes and establish whether these states provide information beyond standard clinical factors. The objective of this study was to develop ReCAST, a donor-aware method that estimates tumour microenvironment cell states from bulk tumour transcriptomes, and to test whether these estimates improved survival prediction in esophageal cancer beyond routine clinical variables.