Preoperative neutrophil-to-lymphocyte ratio predicts recurrence of esophageal squamous cell carcinoma after neoadjuvant triplet chemotherapy.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

General Thoracic and Cardiovascular Surgery Pub Date : 2024-12-01 Epub Date: 2024-06-24 DOI:10.1007/s11748-024-02053-7

Kentaro Kubo, Shota Igaue, Daichi Utsunomiya, Yuto Kubo, Kyohei Kanematsu, Daisuke Kurita, Koshiro Ishiyama, Junya Oguma, Koichi Goto, Hiroyuki Daiko

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Abstract

Background: Neoadjuvant chemotherapy followed by esophagectomy is the standard treatment for resectable advanced esophageal squamous cell carcinoma (ESCC) in Japan. Triplet chemotherapy is the standard neoadjuvant regimen. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) are well-known prognostic factors for esophageal cancer. However, their usefulness in patients with resectable advanced disease undergoing esophagectomy after neoadjuvant triplet chemotherapy is unknown.

Method: We examined 144 ESCC patients who underwent neoadjuvant triplet chemotherapy followed by esophagectomy between January 2015 and December 2020 to investigate the relationship between inflammatory markers and recurrence-free survival (RFS). Optimal marker cutoff values for RFS were determined using receiver operating characteristic curve analysis. Patients were divided into high and low NLR groups (NLR cutoff, 3.0).

Results: NLR was high in 61 patients and low in 83. Univariate analyses demonstrated that low NLR was significantly associated with worse RFS (p = 0.049). Multivariate analyses demonstrated that high NLR was an independent predictor of RFS (odds ratio, 1.911; 95% confidence interval, 1.098-3.327; p = 0.022). RFS significantly differed between the low and high NLR groups. RFS did not significantly differ between the patients when stratified according to the other inflammatory markers.

Conclusion: Preoperative NLR is an easily obtained and useful predictor of RFS in patients with resectable advanced ESCC treated with neoadjuvant triplet chemotherapy followed by esophagectomy.

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术前中性粒细胞与淋巴细胞比值可预测新辅助三联化疗后食管鳞状细胞癌的复发。

背景：在日本，新辅助化疗后进行食管切除术是可切除的晚期食管鳞状细胞癌（ESCC）的标准治疗方法。三联化疗是标准的新辅助治疗方案。中性粒细胞与淋巴细胞比值（NLR）等炎症指标是众所周知的食管癌预后因素。然而，这些指标在新辅助三联化疗后接受食管切除术的可切除晚期患者中的作用尚不清楚：我们研究了2015年1月至2020年12月期间接受新辅助三联化疗后食管切除术的144例ESCC患者，以探讨炎症标志物与无复发生存期（RFS）之间的关系。采用接收者操作特征曲线分析法确定了RFS的最佳标志物截断值。患者被分为高NLR组和低NLR组（NLR临界值为3.0）：结果：61 名患者的 NLR 值较高，83 名患者的 NLR 值较低。单变量分析表明，低 NLR 与较差的 RFS 显著相关（p = 0.049）。多变量分析表明，高 NLR 是 RFS 的独立预测因素（几率比 1.911；95% 置信区间 1.098-3.327；p = 0.022）。低 NLR 组和高 NLR 组的 RFS 有明显差异。根据其他炎症指标进行分层后，RFS在患者之间无明显差异：结论：对于接受新辅助三联化疗后再行食管切除术的可切除晚期 ESCC 患者，术前 NLR 是一种易于获得且有效的 RFS 预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine

CiteScore

2.70

自引率

8.30%

发文量

142

期刊介绍： The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.