Comparison of Inflammation-Based Prognostic Scores in a Cohort of Patients with Resectable Esophageal Cancer

Abstract

Background A number of studies have revealed that inflammation-based prognostic scores, such as Glasgow prognostic score (GPS), modified Glasgow prognostic score (mGPS), and C-reactive protein and albumin ratio (C/A ratio), are associated with poor outcome in cancer patients. However, until now, no study has investigated the role of these prognostic scores in a cohort of neoadjuvant-treated esophageal adenocarcinomas (nEAC) and squamous cell carcinomas (nESCC). Methods Patients had laboratory measurements within three days before resection. GPS, mGPS, and C/A ratio were tested together with established clinicopathological factors in simple and multiple Cox regression analysis of overall survival (OS) and disease-free survival (DFS). Results A total of 283 patients (201 EAC and 82 ESCC) with locally advanced esophageal cancer were enrolled. 167 patients received neoadjuvant treatment (59.0%). Simple analysis revealed that there were significant differences in cancer-specific survival in relation to elevated C-reactive protein (p = 0.011), lymph node status (p < 0.001), UICC stage (p < 0.001), and nEAC (p = 0.005). mGPS (p = 0.024) showed statistical significance in simple analysis. No statistical significance could be found for GPS (p = 0.29), mGPS (p = 0.16), and C/A ratio (p = 0.76) in multiple analysis. Conclusion The investigated prognostic scores should be used and interpreted carefully, and established factors like histology, including tumor size and differentiation, lymph node involvement, and status of resection margin remain the only reliable prognostic factors for patients suffering from resectable EC.

The value of preoperative Glasgow Prognostic Score and the C-Reactive Protein to Albumin Ratio as prognostic factors for long-term survival in pathological T1N0 esophageal squamous cell carcinoma

“…As previous studies, the patients who were classified into the group of score 2 were limited (only 1 case in this study) 19 , 20 . Xiao-li Wei et al, Xiao-ling Xu et al and G. Jomrich et al had reported that high GPS (1-2) was not significantly associated with shorter OS in non-selected or resectable ESCC patients, but, multivariate analysis identified that GPS (0/1-2) was the independent prognostic factor for 10-year OS among stage T1N0 ESCC in our study 20 - 22 , which was in accordance with the result from N. Hirahara et al among elderly ESCC patients (age≥70 years) 19 . In 2007, the first study in colon and rectal cancer from McMillan DC et al indicated that the modified GPS (mGPS) was significantly associated with overall survival 23 .…”

Systemic Immune-Inflammation Index (SII) Predicts Poor Survival in Pancreatic Cancer Patients Undergoing Resection

“…[4][5][6] The major prognostic impact of inflammatory markers can be ascribed to a cytokine-driven immunogenic tumor microenvironment and a significant prognostic role of inflammation-based biomarkers and scores has recently been shown in a number of malignant diseases. 5,7,[26][27][28] One of the newly emerging prognostic scores is the SII, based on platelets, neutrophils, and lymphocytes. As a combination of both NLR and PLR, SII firstly has been confirmed as superior prognostic factor in hepatocellular carcinoma and then in small cell lung cancer reflecting patient's inflammatory status.…”

The modified glasgow prognostic score is an independent prognostic indicator in neoadjuvantly treated adenocarcinoma of the esophagogastric junction

“…This data goes in good accordance with our recently published data, that shows, that albumin and CRP based prognostic scores have to be used carefully in EC patients. Nevertheless, in the subgroup of neoadjuvantly treated AEG patients, we found the mGPS to be a prognostic marker [ 27 ]. Therefore, we evaluated the mGPS in a cohort neoadjuvantly treated AEG patients in this underlying study.…”