Prognostic significance of serum inflammatory markers in esophageal cancer

被引:19
作者
Powell, Arfon G. M. T. [1 ]
Eley, Catherine [2 ]
Chin, Carven [2 ]
Coxon, Alexandra H. [2 ]
Christian, Adam [3 ]
Lewis, Wyn G. [2 ]
机构
[1] Cardiff Univ, Univ Wales Hosp, Div Canc & Genet, Heath Pk, Cardiff, Wales
[2] Univ Hosp Wales, Cardiff & Vale Univ Hlth Board, Dept Surg, Heath Pk, Cardiff, Wales
[3] Univ Hosp Wales, Cardiff & Vale Univ Hlth Board, Dept Pathol, Heath Pk, Cardiff, Wales
关键词
Esophageal cancer; Systemic inflammation; Survival; TO-LYMPHOCYTE RATIO; NEOADJUVANT THERAPY; SCORE; CHEMOTHERAPY; SURGERY; TUMOR;
D O I
10.1007/s10388-020-00772-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background The aim of this study was to assess the relative prognostic value of biomarkers to measure the systemic inflammatory response (SIR) and potentially improve prognostic modeling in patients undergoing potentially curative surgery for esophageal adenocarcinoma (EC). Methods Consecutive 330 patients undergoing surgery for EC between 2004 and 2018 within a regional UK cancer network were identified. Serum measurements of haemoglobin, C-reactive protein, albumin, modified Glasgow Prognostic Score (mGPS), and differential neutrophil to lymphocyte ratio (NLR) were obtained before surgery, and correlated with histopathological factors and outcomes. Primary outcome measures were disease-free (DFS) and overall survival (OS). Results Of 330 OC patients, 294 underwent potentially curative esophagectomy. Univariable DFS analysis revealed pT, pN, pTNM stage (allp < 0.001), poor differentiation (p = 0.001), vascular invasion (p < 0.001), R1 status (p < 0.001), perioperative chemotherapy (p = 0.009), CRP (p = 0.010), mGPS (p = 0.011), and NLR (p < 0.001), were all associated with poor survival. Multivariable Cox regression analysis of DFS revealed only NLR [Hazard Ratio (HR) 3.63, 95% Confidence Interval (CI) 2.11-6.24,p < 0.001] retained significance. Multivariable Cox regression analysis of OS revealed similar findings: NLR [HR 2.66, (95% CI 1.58-4.50),p < 0.001]. Conclusion NLR is an important SIR prognostic biomarker associated with DFS and OS in EC.
引用
收藏
页码:267 / 277
页数:11
相关论文
共 36 条
[1]   Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer [J].
Al Murri, AM ;
Bartlett, JMS ;
Canney, PA ;
Doughty, JC ;
Wilson, C ;
McMillan, DC .
BRITISH JOURNAL OF CANCER, 2006, 94 (02) :227-230
[2]   ESPEN expert group recommendations for action against cancer-related malnutrition [J].
Arends, J. ;
Baracos, V. ;
Bertz, H. ;
Bozzetti, F. ;
Calder, P. C. ;
Deutz, N. E. P. ;
Erickson, N. ;
Laviano, A. ;
Lisanti, M. P. ;
Lobo, D. N. ;
McMillan, D. C. ;
Muscaritoli, M. ;
Ockenga, J. ;
Pirlich, M. ;
Strasser, F. ;
de van der Schueren, M. ;
Van Gossum, A. ;
Vaupel, P. ;
Weimann, A. .
CLINICAL NUTRITION, 2017, 36 (05) :1187-1196
[3]  
Cancer Research UK, OES CANC SURV STAT
[4]   Systemic inflammatory response is a predictor of outcome in patients undergoing preoperative chemoradiation for locally advanced rectal cancer [J].
Carruthers, R. ;
Tho, L. M. ;
Brown, J. ;
Kakumanu, S. ;
McCartney, E. ;
McDonald, A. C. .
COLORECTAL DISEASE, 2012, 14 (10) :E701-E707
[5]  
Cederholm T, 2019, CLIN NUTR, V38, P1480, DOI [10.1016/j.clnu.2019.02.033, 10.1002/jcsm.12383, 10.1002/jpen.1440, 10.1016/j.clnu.2018.08.002]
[6]   Influence of a Regional Centralised Upper Gastrointestinal Cancer Service Model on Patient Safety, Quality of Care and Survival [J].
Chan, D. S. Y. ;
Reid, T. D. ;
White, C. ;
Willicombe, A. ;
Blackshaw, G. ;
Clark, G. W. ;
Havard, T. J. ;
Escofet, X. ;
Crosby, T. D. L. ;
Roberts, S. A. ;
Lewis, W. G. .
CLINICAL ONCOLOGY, 2013, 25 (12) :719-725
[7]   Cancer-related inflammation, the seventh hallmark of cancer: links to genetic instability [J].
Colotta, Francesco ;
Allavena, Paola ;
Sica, Antonio ;
Garlanda, Cecilia ;
Mantovani, Alberto .
CARCINOGENESIS, 2009, 30 (07) :1073-1081
[8]   Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer [J].
Cunningham, David ;
Allum, William H. ;
Stenning, Sally P. ;
Thompson, Jeremy N. ;
Van de Velde, Cornelis J. H. ;
Nicolson, Marianne ;
Scarffe, J. Howard ;
Lofts, Fiona J. ;
Falk, Stephen J. ;
Iveson, Timothy J. ;
Smith, David B. ;
Langley, Ruth E. ;
Verma, Monica ;
Weeden, Simon ;
Chua, Yu Jo .
NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (01) :11-20
[9]   An exploratory study examining the relationship between performance status and systemic inflammation frameworks and cytokine profiles in patients with advanced cancer [J].
Dolan, Ross D. ;
Laird, Barry J. A. ;
Klepstad, Pal ;
Kaasa, Stein ;
Horgan, Paul G. ;
Paulsen, Ornulf ;
McMillan, Donald C. .
MEDICINE, 2019, 98 (37)
[10]   The prognostic value of systemic inflammation in patients undergoing surgery for colon cancer: comparison of composite ratios and cumulative scores [J].
Dolan, Ross D. ;
McSorley, Stephen T. ;
Park, James H. ;
Watt, David G. ;
Roxburgh, Campbell S. ;
Horgan, Paul G. ;
McMillan, Donald C. .
BRITISH JOURNAL OF CANCER, 2018, 119 (01) :40-51