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. 2024 Mar-Apr;38(2):881-889.
doi: 10.21873/invivo.13514.

Survival Predictors Before Preoperative Adjuvant Chemotherapy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma

Itaru Hashimoto #  1   2 , Kazuki Kano #  1   2 , Hideaki Suematsu  1   2 , Takanobu Yamada  1   2 , Hayato Watanabe  1   2 , Kyohei Kanematsu  1 , Shinsuke Nagasawa  1   2 , Toru Aoyama  2 , Takashi Ogata  1 , Yasushi Rino  2 , Aya Saito  2 , Takashi Oshima  3
Affiliations

Survival Predictors Before Preoperative Adjuvant Chemotherapy in Patients With Locally Advanced Esophageal Squamous Cell Carcinoma

Itaru Hashimoto et al. In Vivo. 2024 Mar-Apr.

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.

Keywords: Albumin; body mass index; esophageal cancer; geriatric nutritional risk index; prognosis survival rate.

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Conflict of interest statement

The Authors declare that there are no conflicts of interest regarding this study.

Figures

Figure 1
Figure 1. Kaplan-Meier OS curves according to the Geriatric Nutritional Risk Index. The median follow-up period was 34.13 (interquartile range=17.22-64.49) months. The 5-year OS rates were 23.3%, 40.2%, and 77.7% in Groups 2, 1, and 0, respectively, which were significantly different among the three groups (p<0.001). OS: Overall survival.
Figure 2
Figure 2. Kaplan-Meier RFS) curves according to the Geriatric Nutritional Risk Index. The 5-year RFS rates were 14.0%, 34.5%, and 68.4% in Groups 2, 1, and 0, respectively, which were significantly different among the three groups (p<0.001). RFS: Relapse-free survival.
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References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi: 10.3322/caac.21660. - DOI - PubMed
    1. Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, Nakamura T, Yabusaki H, Aoyama N, Kurita A, Ikeda K, Kanda T, Tsujinaka T, Nakamura K, Fukuda H. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907) Ann Surg Oncol. 2012;19(1):68–74. doi: 10.1245/s10434-011-2049-9. - DOI - PubMed
    1. van Hagen P, Hulshof MC, van Lanschot JJ, Steyerberg EW, van Berge Henegouwen MI, Wijnhoven BP, Richel DJ, Nieuwenhuijzen GA, Hospers GA, Bonenkamp JJ, Cuesta MA, Blaisse RJ, Busch OR, ten Kate FJ, Creemers GJ, Punt CJ, Plukker JT, Verheul HM, Spillenaar Bilgen EJ, van Dekken H, van der Sangen MJ, Rozema T, Biermann K, Beukema JC, Piet AH, van Rij CM, Reinders JG, Tilanus HW, van der Gaast A, CROSS Group Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–2084. doi: 10.1056/NEJMoa1112088. - DOI - PubMed
    1. Takeuchi H, Ikeuchi S, Kitagawa Y, Shimada A, Oishi T, Isobe Y, Kubochi K, Kitajima M, Matsumoto S. Pretreatment plasma fibrinogen level correlates with tumor progression and metastasis in patients with squamous cell carcinoma of the esophagus. J Gastroenterol Hepatol. 2007;22(12):2222–2227. doi: 10.1111/j.1440-1746.2006.04736.x. - DOI - PubMed
    1. Tomimaru Y, Yano M, Takachi K, Kishi K, Miyashiro I, Ohue M, Ohigashi H, Sasaki Y, Ishikawa O, Imaoka S. Correlation between pretherapeutic d-dimer levels and response to neoadjuvant chemotherapy in patients with advanced esophageal cancer. Dis Esophagus. 2008;21(4):281–287. doi: 10.1111/j.1442-2050.2007.00758.x. - DOI - PubMed