Impact of inflammation-based prognostic score on survival after curative thoracoscopic esophagectomy for esophageal cancer

• Published in: European journal of surgical oncology Vol. 41; no. 10; pp. 1308 - 1315
• Main Authors: Hirahara, N, Matsubara, T, Hayashi, H, Takai, K, Fujii, Y, Tajima, Y
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2015
• Subjects: Age Factors; Aged; C-Reactive Protein - immunology; Carcinoma, Squamous Cell - immunology; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Cholesterol - blood; Cohort Studies; Esophageal cancer; Esophageal Neoplasms - immunology; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophageal Squamous Cell Carcinoma; Esophagectomy; Female; Glasgow Prognostic Score; Hematology, Oncology and Palliative Medicine; Humans; Inflammation; Leukocyte Count; Lymph Node Excision; Lymphocyte Count; Male; Middle Aged; Multivariate Analysis; Neoplasm Staging; Neutrophil lymphocyte ratio; Neutrophils - immunology; Prognosis; Retrospective Studies; Serum Albumin - metabolism; Surgery; Thoracoscopy; Glasgow Prognostic Score; Prognosis; Neutrophil lymphocyte ratio; Esophageal cancer
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2015.07.008

Abstract Background Despite recent improvements in early detection, progress in surgical techniques, and development of chemoradiation therapies, prognosis of esophageal cancer remains poor. The aim of the present study was to assess whether Glasgow Prognostic Score (GPS), an inflammation-based prognostic score, has prognostic value independent of conventional clinicopathological criteria in patients undergoing curative resection for esophageal cancer, even in elderly patients. Methods We retrospectively reviewed the database of 141 consecutive patients with histologically verified esophageal squamous cell carcinoma who underwent potentially curative surgery in our institute, between January 2006 and December 2014. GPS and neutrophil lymphocyte ratio (NLR) were calculated. Results On multivariate analysis, TNM stage (p < 0.0001) and GPS (p = 0.041) were independently associated with worse prognosis in overall patients with esophageal cancer. Multivariate analysis evaluated the prognostic factors in two different patient groups: patients younger than 70 years (non-elderly) and those aged 70 years or more (elderly). Multivariate analysis demonstrated that TNM stage (p = 0.0003) was an only independent risk factor for a worse prognosis among non-elderly group. Meanwhile, multivariate analysis demonstrated that TNM stage (p = 0.001) and GPS (p = 0.043) were the independent risk factor for a worse prognosis among elderly group. Conclusion The present study demonstrated that GPS is associated with prognosis and can be considered as an independent prognostic marker in patients who underwent esophagectomy. Moreover, the GPS has the advantage of being simple to measure, routinely available and well standardized. But the present study failed to confirm the NLR as a significant predictor of survival following resection for esophageal cancer.