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- Title
Survival Predictors Before Preoperative Adjuvant Chemotherapy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma.
- Authors
ITARU HASHIMOTO; KAZUKI KANO; HIDEAKI SUEMATSU; TAKANOBU YAMADA; HAYATO WATANABE; KYOHEI KANEMATSU; SHINSUKE NAGASAWA; TORU AOYAMA; TAKASHI OGATA; YASUSHI RINO; AYA SAITO; TAKASHI OSHIMA
- Abstract
Background/Aim: Radical resection after preoperative adjuvant chemotherapy (NAC) is a standard treatment for patients with locally advanced esophageal squamous cell carcinoma (LAESCC), but its outcome remains unsatisfactory. In order to develop a personalized treatment program for LAES, we herein compared the survival prediction utility of five pre-NAC nutritional, inflammatory, and immune indexes in patients with LAESCC. Patients and Methods: We evaluated the survival of 203 patients with LAESCC who underwent radical resection after NAC from January 2011 to September 2019 for the following representative pre-NAC nutritional, inflammatory, and immune indices: modified Glasgow Prognostic Score, Prognostic Nutritional Index, C-reactive protein/albumin ratio, serum neutrophil/lymphocyte ratio, and Geriatric Nutrition Risk Index (GNRI) were evaluated for their impact on survival. Results: Of the five indices, GNRI was the best predictor of survival as determined by the area under the curve (p<0.05). When patients were divided into three groups according to the nutritional risk assessment of Bouillanne et al. using the pre-NAC GNRI, the 5-year overall survival (OS) and recurrence-free survival (RFS) were significantly stratified (p<0.001). On multivariate analysis, the GNRI independently identified a poor OS group [group 1: hazard ratio (HR)=2.598, p=0.002; group 2: HR=6.257, p<0.001] and a high recurrence risk group (group 1: HR=1.967, p=0.016; group 2: HR=4.467, p<0.001). Conclusion: In patients with LAESCC, GNRI may be the most accurate, reliable, and useful prognostic factor among the five major systemic inflammatory and nutritional indices.
- Subjects
TREATMENT of esophageal cancer; ADJUVANT chemotherapy; SQUAMOUS cell carcinoma; PREOPERATIVE care; C-reactive protein
- Publication
In Vivo, 2024, Vol 38, Issue 2, p881
- ISSN
0258-851X
- Publication type
Article
- DOI
10.21873/invivo.13514