A new inflammation index is useful for patients with esophageal squamous cell carcinoma

Abstract

BackgroundThe prognostic value of inflammation indexes in esophageal cancer has not been established. Recent studies have shown that the advanced lung cancer inflammation index (ALI) is a useful predictive factor. The purpose of the current study was to determine whether the ALI is useful for predicting long-term survival in patients with esophageal squamous cell carcinoma (ESCC).Patients and methodsA total of 293 patients who had undergone esophagectomy for ESCC were included. The ALI was calculated as body mass index × serum albumin/neutrophil-to-lymphocyte ratio. Then, patients were divided into two groups: ALI ≥18 and ALI <18. The Kaplan–Meier method was used to calculate the cancer-specific survival (CSS), and the difference was assessed by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic factors.ResultsIn our study, there were 120 patients with ALI <18 and 173 patients with ALI ≥18. ALI was significantly higher in patients with large tumors (P=0.028), poor differentiation (P=0.010), deep invasion (P=0.009), and nodal metastasis (P=0.004). The 5-year CSS was 34.5% in our study. Patients with ALI <18 had a significantly poorer 5-year CSS compared to ALI ≥18 (21.7% versus 43.4%, P<0.001). On multivariate analysis, we showed that the ALI was a significant predictive factor of CSS (P=0.024).ConclusionThe ALI is still a useful predictive factor for long-term CSS in patients with ESCC. However, the prognostic value of the ALI is yet to be formally tested within randomized trials.

Prognostic Value of the Pretreatment Advanced Lung Cancer Inflammation Index (ALI) in Diffuse Large B Cell Lymphoma Patients Treated with R-CHOP Chemotherapy

“…Recently, a low ALI at diagnosis was reported to indicate poor prognosis in patients with non-small-cell lung cancer (NSCLC), small-cell lung cancer, and squamous-cell carcinoma of the esophagus [24,25,26]. Jafri et al [24 ]reported that advanced NSCLC patients with an ALI of <18 at diagnosis had poorer survival outcomes than patients with an ALI of ≥18.…”

“…Jafri et al [24 ]reported that advanced NSCLC patients with an ALI of <18 at diagnosis had poorer survival outcomes than patients with an ALI of ≥18. Feng et al [25 ]reported that an ALI of <18 usefully predicted poor survival in patients who underwent an esophagectomy for esophageal squamous-cell carcinoma. Because recent studies have demonstrated that the host inflammatory response shapes the biological characteristics of B cell lymphoma, we hypothesized that pretreatment ALI (a systemic inflammatory index) might predict response to treatment and survival in DLBCL.…”

“…Different ALI cut-off values, including 18 and 19.5, have been used in previous studies on solid tumors [24,25,26]. In this study, the pretreatment ALI cut-off (i.e., the most discriminatory cut-off threshold) was calculated as 15.5 by ROC analysis.…”

“…The assessment of inflammatory response to a tumor using these laboratory markers is relatively straightforward and cost-effective in clinical practice. Recently, Jafri et al [24 ]developed a novel inflammation-based prognostic system, called the Advanced Lung Cancer Inflammation Index (ALI; based on body mass index [BMI], serum albumin level, and NLR), and other study groups have reported that low ALI is significantly associated with poor overall survival (OS) in patients with advanced lung cancer or esophageal squamous-cell carcinoma [24,25,26]. To the best of our knowledge, ALI has not been previously investigated in the context of hematologic malignancies, including lymphomas.…”

Validation of a novel prognostic scoring system using inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma

“…Based on this, a number of inflammatory-based prognostic markers have been identified, such as the Glasgow Prognostic Score (GPS), modified GPS (mGPS), and Prognostic Nutritional Index (PNI), in esophageal cancer 4–6. However, only a few studies have evaluated the utility of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for assessing the prognosis of patients with esophageal cancer 7–9. Previous studies revealed that high LMR and NLR, and low PLR are the strong predictors of postoperative survival in several types of cancer 7–9.…”