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Prognostic significance of serum inflammatory markers in esophageal cancer.

Authors
  • Powell, Arfon G M T1
  • Eley, Catherine2
  • Chin, Carven2
  • Coxon, Alexandra H2
  • Christian, Adam3
  • Lewis, Wyn G2
  • 1 Division of Cancer and Genetics, University Hospital of Wales, Cardiff University, Heath Park, Cardiff, UK. [email protected]
  • 2 Department of Surgery, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK.
  • 3 Department of Pathology, Cardiff & Vale University Health Board, University Hospital of Wales, Heath Park, Cardiff, UK.
Type
Published Article
Journal
Esophagus : official journal of the Japan Esophageal Society
Publication Date
Apr 01, 2021
Volume
18
Issue
2
Pages
267–277
Identifiers
DOI: 10.1007/s10388-020-00772-3
PMID: 32865623
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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). 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). Of 330 OC patients, 294 underwent potentially curative esophagectomy. Univariable DFS analysis revealed pT, pN, pTNM stage (all p < 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]. NLR is an important SIR prognostic biomarker associated with DFS and OS in EC.

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