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

Abstract

BackgroundSystemic inflammatory markers, including the lymphocyte-to-monocyte ratio, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio have been shown to predict postoperative recurrence and survival in various types of cancer. However, their role in esophageal cancer has yet to be determined. This study aimed to evaluate the prognostic significance of an inflammatory response biomarker (IRB) score, independent of conventional clinicopathological criteria, in patients with esophageal cancer undergoing curative resection.Patients and methodsWe retrospectively reviewed a database containing the medical records of 147 consecutive patients who underwent curative esophagectomy for esophageal squamous cell carcinoma. The IRB score was determined as follows: a low lymphocyte-to-monocyte ratio (<4), a low neutrophil-to-lymphocyte ratio (<1.6), and a high platelet-to-lymphocyte ratio (>147), which were each scored as 1, with all remaining values scored as 0. The scores were added together to produce the IRB score (range: 0–3).ResultsAn IRB score of 2–3 (hazard ratio: 6.023, 95% confidence interval: 1.675–13.078; P<0.01) was identified as an independent poor prognostic factor of cancer-specific survival (CSS) in a multivariate logic regression analysis. The 5-year CSS rates in patients with the IRB scores of 0−1, 2, and 3 were 37.8%, 67.8%, and 72.5%, respectively. As determined by Kaplan–Meier analysis and the log-rank test, these differences were significant (P<0.001).ConclusionThe IRB score can predict the systemic inflammatory response as accurately as conventional tumor markers and is useful for determining CSS in patients with esophageal cancer undergoing curative thoracoscopic esophagectomy.

Prognostic role of platelet to lymphocyte ratio in esophageal cancer: A meta-analysis

“…We eliminated 83 articles for various reasons based on the title and abstract, leaving 29 studies to scrutinize with a full text review. Of the 29 studies, three were reported by the same study center and the patients were overlapping or partly overlapping in the studies [ 15 , 17 , 18 ]. To avoid duplicate counting, only one study with more complete data was selected [ 15 ].…”

The Preoperative Lymphocyte to Monocyte Ratio Predicts Clinical Outcome In Resected Patients With T2-4N0-3M0 Siewert Type II/III Adenocarcinoma Of The Esophagogastric Junction

“…In our study, we set 3.64 as the cut-off levels for the LMR by applying ROC curve analysis, different from some other studies, such as 4.0 in the study by Hirahara N [24] , 2.86 in pancreatic adenocarcinoma by Li's study [25] , a decreased peripheral lymphocyte to monocyte ratio (LMR) has been identifed as a poorer prognostic indicator in various cancers [26,27] .From Table 2, we found that the median of Lymphocyte count was higher in 'LMR 3.64'(1.9) than in 'LMR ≤ 3.64' (1.3). The median of monocyte count was nearly the same in two groups(0.3vs0.4).…”

Serological Biomarkers and Diversion Colitis: Changes after Stimulation with Probiotics

“…The sample size was calculated according to the cut-off values of inflammatory biomarkers ROC curves published in previous studies [ 3 , 4 , 5 , 6 , 7 , 8 ]. 50% of reduction/normalisation of pathological biomarkers (50 to 100%) was assumed.…”

“…High levels of CRP, acute phase reactant, and low levels of albumin, related to malnutrition and intestinal disorders, reflect a systemic inflammatory response. These can be used as prognostic predictors, already available in daily practice [ 8 ], together with other inflammatory response biomarkers (IRB) such as transferrin, the neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR) and the lymphocyte/monocyte ratio (LMR).…”