Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Fachpsychotherapie Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende Patientenratgeber
Erweiterte Suche
Anmelden
nach oben
Annals of Surgical Oncology
Erschienen in:

10.03.2021 | Thoracic Oncology

Usefulness of Neutrophil to Lymphocyte Ratio at Recurrence for Predicting Long-Term Outcomes in Patients with Recurrent Esophageal Squamous Cell Carcinoma

verfasst von: Shota Hoshino, MD, Masashi Takeuchi, MD, PhD, Hirofumi Kawakubo, MD, PhD, Satoru Matsuda, MD, PhD, Shuhei Mayanagi, MD, PhD, Tomoyuki Irino, MD, PhD, Kazumasa Fukuda, PhD, Rieko Nakamura, MD, PhD, Norihito Wada, MD, PhD, Yuko Kitagawa, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 6/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

Although radical esophagectomy with multifield lymph node dissection is a promising treatment to achieve long-term survival for resectable esophageal cancer, survival after postoperative recurrence remains poor. To select the optimal treatment for patients with recurrent esophageal cancer, simple, objective indicators for predicting of long-term outcomes are needed.

Patients and Methods

We conducted a single-institution, retrospective cohort study between 2004 and 2019, wherein 586 patients underwent transthoracic esophagectomy for primary esophageal squamous cell carcinoma. Of these, 133 patients with postoperative recurrence were included in this analysis. Several predictors of survival after recurrence were investigated.

Results

Among all patients, the 1- and 3-year survival rates after recurrence were 48.0% and 23.1%, respectively. On multivariate analysis, the neutrophil to lymphocyte ratio (NLR) at recurrence was identified as a significant predictor of death after recurrence (hazard ratio 1.061; 95% confidence interval 1.002–1.125; p = 0.043). Time-dependent receiver operating characteristics curves showed that the area under the curve value of the NLR at recurrence was superior to the modified Glasgow Prognostic Score at recurrence in all terms. To simulate the clinical decision process, we set the cut-off NLR at recurrence for survival using survival classification and regression tree (CART) and defined the optimal cut-off value as 3.374.

Conclusions

NLR at recurrence was a significant indicator of survival after recurrence in patients with recurrent esophageal cancer. CART analysis was used to determine the optimal cut-off value for the prediction of survival, allowing the NLR to be used clinically to facilitate decision making.
Literatur
1.
Takeuchi M, Takeuchi H, Kawakubo H, et al. Perioperative risk calculator predicts long-term oncologic outcome for patients with esophageal carcinoma. Ann Surg Oncol. 2018;25:837–43.CrossRefPubMed
2.
3.
Ichida H, Imamura H, Yoshimoto J, et al. Pattern of postoperative recurrence and hepatic and/or pulmonary resection for liver and/or lung metastases from esophageal carcinoma. World J Surg. 2013;37:398–407.CrossRefPubMed
4.
5.
Kosugi SI, Kanda T, Yajima K, Ishikawa T, Hatakeyama K. Risk factors that influence early death due to cancer recurrence after extended radical esophagectomy with three-field lymph node dissection. Ann Surg Oncol. 2011;18:2961–7.CrossRefPubMed
6.
DeNardo DG, Johansson M, Coussens LM. Immune cells as mediators of solid tumor metastasis. Cancer Metastas Rev. 2008;27:11–8.CrossRef
7.
Kwon HC, Kim SH, Oh SY, et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17:216–22.CrossRefPubMed
8.
Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer. Oncology. 2007;73:215–20.CrossRefPubMed
9.
Jomrich G, Paireder M, Gleiss A, Kristo I, Harpain L, Schoppmann SF. Comparison of inflammation-based prognostic scores in a cohort of patients with resectable esophageal cancer. Gastroenterol Res Pract. 2017;2017:1678584.CrossRefPubMedCentralPubMed
10.
Sato H, Tsubosa Y, Kawano T. Correlation between the pretherapeutic neutrophil to lymphocyte ratio and the pathologic response to neoadjuvant chemotherapy in patients with advanced esophageal cancer. World J Surg. 2012;36:617–22.CrossRefPubMed
11.
McMillan DC, Crozier JEM, Canna K, Angerson WJ, McArdle CS. Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis. 2007;22:881–6.CrossRefPubMed
12.
Crumley AB, Stuart RC, McKernan M, McDonald AC, McMillan DC. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG-ps) in patients receiving palliative chemotherapy for gastroesophageal cancer. J Gastroenterol Hepatol. 2008;23:e325–9.CrossRefPubMed
13.
Jung MR, Park YK, Jeong O, et al. Elevated preoperative neutrophil to lymphocyte ratio predicts poor survival following resection in late stage gastric cancer. J Surg Oncol. 2011;104:504–10.CrossRefPubMed
14.
Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005;91:181–4.CrossRefPubMed
15.
Rice TW, Patil DT, Blackstone EH. 8th edition AJCC/UICC staging of cancers of the esophagus and esophagogastric junction: application to clinical practice. Ann Cardiothorac Surg. 2017;6:119–30.CrossRefPubMedCentralPubMed
16.
Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74.CrossRefPubMed
17.
18.
19.
Marshall RJ. The use of classification and regression trees in clinical epidemiology. J Clin Epidemiol. 2001;54:603–9.CrossRefPubMed
20.
Garzotto M, Beer TM, Hudson RG, et al. Improved detection of prostate cancer using classification and regression tree analysis. J Clin Oncol. 2005;23:4322–9.CrossRefPubMed
21.
Zhou YQ, Ding NX, Wang LJ, Liu W, Jiang M, Lu JC. Salvage radiochemotherapy for lymph node recurrence after radical surgery of esophageal cancer. Med (United States). 2018;97:e9777.
22.
23.
Kawamoto T, Nihei K, Sasai K, Karasawa K. Clinical outcomes and prognostic factors of chemoradiotherapy for postoperative lymph node recurrence of esophageal cancer. Jpn J Clin Oncol. 2018;48:259–64.CrossRefPubMed
24.
Sharaiha RZ, Halazun KJ, Mirza F, et al. Elevated preoperative neutrophil: lymphocyte ratio as a predictor of postoperative disease recurrence in esophageal cancer. Ann Surg Oncol. 2011;18:3362–9.CrossRefPubMedCentralPubMed
25.
Terzić J, Grivennikov S, Karin E, Karin M. Inflammation and colon cancer. Gastroenterology. 2010;138(2101–2114):e5.
26.
27.
Gregory AD, Houghton AMG. Tumor-associated neutrophils: new targets for cancer therapy. Cancer Res. 2011;71:2411–6.CrossRefPubMed
28.
29.
30.
Huber C, Bobek N, Kuball J, et al. Inhibitors of apoptosis confer resistance to tumour suppression by adoptively transplanted cytotoxic T-lymphocytes in vitro and in vivo. Cell Death Differ. 2005;12:317–25.CrossRefPubMed
31.
Wu N, Chen G, Hu H, Pang L, Chen Z. Low pretherapeutic serum albumin as a risk factor for poor outcome in esophageal squamous cell carcinomas. Nutr Cancer. 2015;67:481–5.CrossRefPubMed
Metadaten
Titel
Usefulness of Neutrophil to Lymphocyte Ratio at Recurrence for Predicting Long-Term Outcomes in Patients with Recurrent Esophageal Squamous Cell Carcinoma
verfasst von
Shota Hoshino, MD
Masashi Takeuchi, MD, PhD
Hirofumi Kawakubo, MD, PhD
Satoru Matsuda, MD, PhD
Shuhei Mayanagi, MD, PhD
Tomoyuki Irino, MD, PhD
Kazumasa Fukuda, PhD
Rieko Nakamura, MD, PhD
Norihito Wada, MD, PhD
Yuko Kitagawa, MD, PhD
Publikationsdatum
10.03.2021
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 6/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-021-09637-0

Weitere Artikel der Ausgabe 6/2021

ASO Author Reflections: Clinical Correlates of Moderate-Penetrance Genes in Breast Cancer

  • ASO Author Reflections

Is a Vaginectomy Enough or is a Pelvic Exenteration Always Required for Surgical Treatment of Recurrent Cervical Cancer? A Propensity-Matched Study

  • Gynecologic Oncology

Adapting Radicality in Early Cervical Cancer When Quality of Life Becomes a Prominent Issue

  • Gynecologic Oncology

Perioperative and Oncological Outcomes of Combined Hepatectomy with Complete Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Metastatic Colorectal Cancer

  • Peritoneal Surface Malignancy

Decompositions of the Contribution of Treatment Disparities to Survival Disparities in Stage I–II Pancreatic Adenocarcinoma

  • Pancreatic Tumors

Disparities in Gastric Cancer: Can we do better?

  • Gastrointestinal Oncology

Neu im Fachgebiet Chirurgie

Nach Vollremission bei Ösophagus-Ca. – Operation erstmal aussetzen?

Studienziel erreicht, dennoch viele Fragen offen. So lassen sich die Ergebnisse der SANO-Studie zu Active-Surveillance versus sofortigen Ösophagektomie nach neoadjuvanter Komplettremission zusammenfassen. Interessant sind die Daten so oder so.

Nicht weniger Infektionen unter Vakuumversiegelungstherapie

Nach Ergebnissen der britisch-australischen SUNRISE-Studie scheint eine Unterdruck-Wundtherapie Infektionen bei abdominell Notoperierten nicht besser verhindern zu können als eine herkömmliche Wundversorgung.

Vergessene OP-Unterlage erst zwei Monate postoperativ entdeckt

Es sollte nie passieren, passiert aber doch: chirurgisches Material, das unbemerkt im Körper verbleibt. Im vorliegenden Fall wurde der Fremdkörper trotz seiner Größe erst nach zwei Monaten entdeckt – nachdem der Patient fast daran gestorben wäre.

Nur selten ernste Komplikationen bei endoskopischer Sinuschirurgie

Etwa 3% der Menschen mit einer endoskopischen Nasennebenhöhlenoperation entwickeln ausgeprägtes Nasenbluten. Andere Komplikationen, wie Verletzungen des Nervus opticus oder eine Meningitis, treten nur äußerst selten auf, legt eine Registeranalyse nahe.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise