Pretreatment NRS-2002 scores combined with hematologic inflammation markers are independent prognostic factors in patients with resectable thoracic esophageal squamous cell carcinoma

Abstract

BackgroundThe purpose of this study was to investigate the prognostic values of Nutritional Risk Screening 2002 (NRS-2002) and hematologic inflammation markers in patients with esophageal squamous cell carcinoma (ESCC) receiving curative esophagectomy.Materials and methodsA total of 277 patients with ESCC treated with standard curative esophagectomy were retrospectively analyzed. These patients were grouped for further analysis according to the systemic inflammation score (SIS), the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (CNP) score and NRS-2002 score. The Kaplan–Meier method and log-rank test were adopted to calculate and compare the progression-free survival (PFS) and overall survival (OS) rates with these parameters. The Cox proportional hazards model was used to carry out univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were applied to verify the accuracy of SIS, CNP and NRS-2002 for survival prediction.ResultsIn univariate analysis, the following factors were significantly associated with poor PFS and OS: sex, T stage, N stage, TNM stage, SIS, CNP and NRS-2002 (all P<0.05). Furthermore, multivariate Cox regression analysis showed that CNP (hazard ratio [HR]=1.602; 95% confidence interval [CI] 1.341–1.913; P=0.000), NRS-2002 (HR=2.062; 95% CI 1.523–2.792; P=0.000) and TNM stage (HR=1.194; 95% CI 1.058–1.565; P=0.048) were independent prognostic factors for PFS. Correspondingly, CNP (HR=1.707; 95% CI 1.405–2.074; P=0.000), NRS-2002 (HR=2.716; 95% CI 1.972–3.740; P=0.000) and TNM stage (HR=1.363; 95% CI 1.086–1.691; P=0.036) were also independent prognostic factors for OS. Finally, the results of ROC curves indicated that CNP and NRS-2002 were superior to SIS as a predictive factor for PFS or OS in patients with ESCC receiving surgery.ConclusionThis study demonstrated that CNP combined with NRS-2002 is promising as a predictive marker for predicting clinical outcomes in patients with ESCC receiving surgery.

Progress in Applicability of Scoring Systems Based on Nutritional and Inflammatory Parameters for Ovarian Cancer

“…In addition, NRS 2002 nutritional risk screening tool can help in the identification of malnourished patients who need to be given different nutritional support. It provides theoretical support for the formulation of personalized treatment plans and has good guiding and predictive effects on the nutritional screening of patients with colorectal cancer (14). However, NRS is rarely used in patients with gynecological tumors.…”

High neutrophil to lymphocytes ratio is associated with nutritional risk in hospitalised, unselected cancer patients: a cross-sectional study

“…Those patients with higher values of NLR had lower survival probability 15 . In another prospective study performed in preoperative esophageal patients, NLR, PLR and NRS were found to be promising as prognostic factors of progression-free survival 16 .…”

“…Currently, many evaluation methods to screening the nutritional status exist; one is the NRS 2002, a valid method for identifying hospitalised patients at risk and those who will benefit from nutritional treatment 16 . A cohort study adopted the NRS 2002 as a tool for assessing nutritional risk and found this tool can accurately predict the association between nutritional risk and clinical outcome 19 .…”

Preoperative Systemic Inflammation Score Predicts the Prognosis of Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy

“…Furthermore, SIS was found to be used as an alternative to the modified Glasgow Prognostic Score (mGPS) to improve the prediction of clinical outcomes in patients who underwent curative surgical resection of stage I to IV colorectal cancers (CRCs) in the study of Suzuki Y [5]. SIS has also been testified to predict the prognosis of other cancers, for instance, lung cancer [10,11], colorectal cancer [12][13][14], esophageal squamous cell carcinoma [15][16][17], and gastric cancer [18][19][20][21]. So far, no clinical study has found the correlation and prognostic value of SIS for UTUC, which needs further exploration.…”