The prognostic significance of preoperative nutritional/inflammatory markers and clinicopathological features in resectable esophagectomy patients: possibility of nutritional intervention

Background Preoperative inflammatory or nutritional biomarkers and clinicopathological features may be survival predictors in resectable esophageal squamous cell carcinoma. Methods We included 118 patients with resectable squamous esophageal carcinoma (stages I–IV), assessing preoperative CRP- and a...

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Veröffentlicht in:Esophagus : official journal of the Japan Esophageal Society 2023-04, Vol.20 (2), p.234-245
Hauptverfasser: Fujiwara, Yoshinori, Endo, Shunji, Higashida, Masaharu, Kubota, Hisako, Yoshimatsu, Kazuhiko, Ueno, Tomio
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container_title Esophagus : official journal of the Japan Esophageal Society
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creator Fujiwara, Yoshinori
Endo, Shunji
Higashida, Masaharu
Kubota, Hisako
Yoshimatsu, Kazuhiko
Ueno, Tomio
description Background Preoperative inflammatory or nutritional biomarkers and clinicopathological features may be survival predictors in resectable esophageal squamous cell carcinoma. Methods We included 118 patients with resectable squamous esophageal carcinoma (stages I–IV), assessing preoperative CRP- and albumin-based modified Glasgow prognostic score, the modified controlling nutritional status score, C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, pathologic stage, and tumor location(s), looking for correlation with overall survival and relapse-free survival. Using univariate and Cox analysis, we selected the most reliable prognostic factors. Results Five-year overall survival and recurrence-free survival were 54.9% and 48.5%, respectively. C-reactive protein values correlated negatively with hypoalbuminemia ( P  = 0.0036). On univariate analysis, tumor stage, invasion depth, location, nodal involvement, albumin, and modified Glasgow prognostic score were significant prognostic factors for overall and recurrence-free survival. Preoperative C-reactive protein was prognostic factor for overall survival, but not for relapse-free survival ( P  = 0.017, 0.063, respectively). The Cox proportional hazards model showed the modified Glasgow prognostic score to be an independent prognostic factor for relapse-free survival and overall survival after using the stepwise variable selection procedure. Cox analysis including clinicopathological factors and modified Glasgow prognostic scores showed that only tumor location(s) and pathologic stage were independent prognostic factors for overall survival and recurrence-free survival. Conclusion Although the modified Glasgow prognostic score is not superior to pathologic stage and tumor location as a biomarker of preoperative nutrition/inflammation and clinicopathological factors, it remains an important prognostic marker in resectable esophageal cancers. Preoperative decreased inflammatory response and improved nutritional status may contribute to prognosis in patients with esophageal cancer.
doi_str_mv 10.1007/s10388-022-00961-2
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Methods We included 118 patients with resectable squamous esophageal carcinoma (stages I–IV), assessing preoperative CRP- and albumin-based modified Glasgow prognostic score, the modified controlling nutritional status score, C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, pathologic stage, and tumor location(s), looking for correlation with overall survival and relapse-free survival. Using univariate and Cox analysis, we selected the most reliable prognostic factors. Results Five-year overall survival and recurrence-free survival were 54.9% and 48.5%, respectively. C-reactive protein values correlated negatively with hypoalbuminemia ( P  = 0.0036). On univariate analysis, tumor stage, invasion depth, location, nodal involvement, albumin, and modified Glasgow prognostic score were significant prognostic factors for overall and recurrence-free survival. Preoperative C-reactive protein was prognostic factor for overall survival, but not for relapse-free survival ( P  = 0.017, 0.063, respectively). The Cox proportional hazards model showed the modified Glasgow prognostic score to be an independent prognostic factor for relapse-free survival and overall survival after using the stepwise variable selection procedure. Cox analysis including clinicopathological factors and modified Glasgow prognostic scores showed that only tumor location(s) and pathologic stage were independent prognostic factors for overall survival and recurrence-free survival. Conclusion Although the modified Glasgow prognostic score is not superior to pathologic stage and tumor location as a biomarker of preoperative nutrition/inflammation and clinicopathological factors, it remains an important prognostic marker in resectable esophageal cancers. Preoperative decreased inflammatory response and improved nutritional status may contribute to prognosis in patients with esophageal cancer.</description><identifier>ISSN: 1612-9059</identifier><identifier>EISSN: 1612-9067</identifier><identifier>DOI: 10.1007/s10388-022-00961-2</identifier><identifier>PMID: 36327058</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Biomarkers ; Biomarkers, Tumor - metabolism ; C-Reactive Protein - metabolism ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Esophageal cancer ; Esophageal Neoplasms - pathology ; Esophageal Squamous Cell Carcinoma - surgery ; Esophagectomy - methods ; Esophagus ; Gastroenterology ; Humans ; Medical prognosis ; Medicine ; Medicine &amp; Public Health ; Neoplasm Recurrence, Local - surgery ; Nutritional status ; Original Article ; Prognosis ; Proteins ; Squamous cell carcinoma ; Surgical Oncology ; Thoracic Surgery</subject><ispartof>Esophagus : official journal of the Japan Esophageal Society, 2023-04, Vol.20 (2), p.234-245</ispartof><rights>The Author(s) under exclusive licence to The Japan Esophageal Society 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. 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Methods We included 118 patients with resectable squamous esophageal carcinoma (stages I–IV), assessing preoperative CRP- and albumin-based modified Glasgow prognostic score, the modified controlling nutritional status score, C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, pathologic stage, and tumor location(s), looking for correlation with overall survival and relapse-free survival. Using univariate and Cox analysis, we selected the most reliable prognostic factors. Results Five-year overall survival and recurrence-free survival were 54.9% and 48.5%, respectively. C-reactive protein values correlated negatively with hypoalbuminemia ( P  = 0.0036). On univariate analysis, tumor stage, invasion depth, location, nodal involvement, albumin, and modified Glasgow prognostic score were significant prognostic factors for overall and recurrence-free survival. Preoperative C-reactive protein was prognostic factor for overall survival, but not for relapse-free survival ( P  = 0.017, 0.063, respectively). The Cox proportional hazards model showed the modified Glasgow prognostic score to be an independent prognostic factor for relapse-free survival and overall survival after using the stepwise variable selection procedure. Cox analysis including clinicopathological factors and modified Glasgow prognostic scores showed that only tumor location(s) and pathologic stage were independent prognostic factors for overall survival and recurrence-free survival. Conclusion Although the modified Glasgow prognostic score is not superior to pathologic stage and tumor location as a biomarker of preoperative nutrition/inflammation and clinicopathological factors, it remains an important prognostic marker in resectable esophageal cancers. 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Methods We included 118 patients with resectable squamous esophageal carcinoma (stages I–IV), assessing preoperative CRP- and albumin-based modified Glasgow prognostic score, the modified controlling nutritional status score, C-reactive protein, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, pathologic stage, and tumor location(s), looking for correlation with overall survival and relapse-free survival. Using univariate and Cox analysis, we selected the most reliable prognostic factors. Results Five-year overall survival and recurrence-free survival were 54.9% and 48.5%, respectively. C-reactive protein values correlated negatively with hypoalbuminemia ( P  = 0.0036). On univariate analysis, tumor stage, invasion depth, location, nodal involvement, albumin, and modified Glasgow prognostic score were significant prognostic factors for overall and recurrence-free survival. Preoperative C-reactive protein was prognostic factor for overall survival, but not for relapse-free survival ( P  = 0.017, 0.063, respectively). The Cox proportional hazards model showed the modified Glasgow prognostic score to be an independent prognostic factor for relapse-free survival and overall survival after using the stepwise variable selection procedure. Cox analysis including clinicopathological factors and modified Glasgow prognostic scores showed that only tumor location(s) and pathologic stage were independent prognostic factors for overall survival and recurrence-free survival. Conclusion Although the modified Glasgow prognostic score is not superior to pathologic stage and tumor location as a biomarker of preoperative nutrition/inflammation and clinicopathological factors, it remains an important prognostic marker in resectable esophageal cancers. Preoperative decreased inflammatory response and improved nutritional status may contribute to prognosis in patients with esophageal cancer.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>36327058</pmid><doi>10.1007/s10388-022-00961-2</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2925-8905</orcidid></addata></record>
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subjects Biomarkers
Biomarkers, Tumor - metabolism
C-Reactive Protein - metabolism
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Esophageal cancer
Esophageal Neoplasms - pathology
Esophageal Squamous Cell Carcinoma - surgery
Esophagectomy - methods
Esophagus
Gastroenterology
Humans
Medical prognosis
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local - surgery
Nutritional status
Original Article
Prognosis
Proteins
Squamous cell carcinoma
Surgical Oncology
Thoracic Surgery
title The prognostic significance of preoperative nutritional/inflammatory markers and clinicopathological features in resectable esophagectomy patients: possibility of nutritional intervention
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