Inflammation-based prognostic scores predict the prognosis of locally advanced cervical esophageal squamous cell carcinoma patients receiving curative concurrent chemoradiotherapy: a propensity score-matched analysis

Chia-Che Wu; Shau-Hsuan Li; Hung-I Lu; Chien-Ming Lo; Yu-Ming Wang; Shang-Yu Chou; Yen-Hao Chen

doi:10.7717/peerj.5655

Inflammation-based prognostic scores predict the prognosis of locally advanced cervical esophageal squamous cell carcinoma patients receiving curative concurrent chemoradiotherapy: a propensity score-matched analysis

PeerJ. 2018 Sep 19:6:e5655. doi: 10.7717/peerj.5655. eCollection 2018.

Authors

Chia-Che Wu^#¹, Shau-Hsuan Li^#¹, Hung-I Lu², Chien-Ming Lo², Yu-Ming Wang³, Shang-Yu Chou³, Yen-Hao Chen^{1

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Affiliations

¹ Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
² Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
³ Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
⁴ Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ School of Medicine, Chung Shan Medical University, Taichung, Taiwan.

^# Contributed equally.

Abstract

Introduction: The present study investigated the crucial role of inflammation-based prognostic scores in locally advanced cervical esophageal squamous cell carcinoma (ESCC) patients who underwent curative concurrent chemoradiotherapy (CCRT).

Methods: There were 411 ESCC patients enrolled, including 63 cervical ESCC patients. Using the propensity score matching method, 63 thoracic ESCC patients were matched to the 63 cervical ESCC patients. The inflammation-based prognostic scores included the neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), albumin level, c-reactive protein (CRP) level, modified Glasgow prognostic score (mGPS), and CRP/albumin ratio. The chi-square test and Kaplan-Meier method were used for categorical variable data and overall survival, respectively. A Cox regression model was performed for univariate and multivariable analyses.

Results: With respect to cervical ESCC, NLR ≥ 2.5 (P = 0.019), PLR ≥ 103 (P = 0.013), CRP value >10 mg/l (P = 0.040), mGPS ≥ 1 (P = 0.040), and CRP/albumin ratio ≥ 9.5 (P = 0.033) were significant predictors of worse overall survival (OS) in the univariate analysis. In a multivariable analysis, PLR ≥ 103 (P = 0.010, HR: 2.66, 95% CI [1.27-5.58]) and mGPS ≥ 1 (P = 0.030, HR: 2.03, 95% CI [1.07-3.86]) were the independent prognostic parameters of worse OS. The prognostic value of these biomarkers in the matched thoracic ESCC patients was similar and compatible with the results in the cervical ESCC group in the univariate and multivariable analyses.

Conclusions: Our study suggests that these inflammation-based prognostic scores are helpful in clinical practice, and PLR and mGPS may predict the prognosis for locally advanced cervical ESCC patients who receive curative CCRT.

Keywords: Concurrent chemoradiotherapy; Esophageal cancer; Inflammation; Propensity score matching; Squamous cell carcinoma.

Grants and funding

This work was supported by grants from the National Science Council, Taiwan (MOST 105-2314-B-182A-029, MOST 106-2314-B-182A-159-MY3, MOST 106-2320-B-182A-015 and MOST 107-2314-B-182A-156-MY3), and Chang Gung Memorial Hospital (CMRPG8G0201, CMRPG8G0891, and CMRPG8E1533). There was no additional external funding received for this study. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.