scholarly journals Systemic Immune-Inflammation Index Predicts Prognosis of Patients With Esophageal Squamous Cell Carcinoma Undergoing Radical Radiotherapy: A Propensity Score-Matched Analysis

2020 ◽  
Author(s):  
Yan Zhao ◽  
Wen-Bin Shen ◽  
Chun-Yang Song ◽  
Jin-Rui Xu ◽  
Shu-Guang Li ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Propensity Score ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Radical Radiotherapy ◽  
Operating Characteristics ◽  
Change Trend ◽  
Immune Inflammation

Abstract BackgroundThe systemic immune-inflammation index (SII) was recently investigated as a prognostic predictor in several kinds of solid tumors, including esophageal squamous cell carcinoma (ESCC) after esophagectomy. However, just few studies regarding SII in patients with ESCC undergoing radical radiotherapy are available. In addition, there has been hardly any report investigating the change trend of SII during radiotherapy. The aim of this study was to identify the prognostic value of SII in ESCC patients undergoing radical radiotherapy. MethodsWe retrospectively reviewed 303 ESCC patients undergoing radical radiotherapy. The change trend of SII was assessed by the box plot and curve fitting method. The time-dependent receiver operating characteristics was used to determine the optimal cutoff value of the SII. The association between SII and survival was determined by Kaplan-Meier method and Cox regression model. Propensity score matching (PSM) was applied to imbalance the baseline characteristics. ResultsHigh SII was associated with poor overall survival (OS) and progression-free survival (PFS) in patients with ESCC undergoing radical radiotherapy. Multivariate analysis showed that SII was a significant predictor for OS and PFS, whether before or after PSM. In addition, SII displayed an exponential increase trend during radiotherapy. The change of SII was also associated with OS and PFS. ConclusionsThe SII is a significant and independent predictor for OS and PFS of ESCC patients undergoing radical radiotherapy. Based on simple and inexpensive standard laboratory measurements, SII can be a promising marker for ESCC patients.

scholarly journals Short-term response might influence the treatment-related benefit of adjuvant chemotherapy after concurrent chemoradiotherapy for esophageal squamous cell carcinoma patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ao Liu ◽  
Yalin Wang ◽  
Xin Wang ◽  
Liqiong Zhu ◽  
Yu Nie ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Concurrent Chemoradiotherapy ◽  
Cox Regression ◽  
Short Term ◽  
Term Response

Abstract Background Whether adjuvant chemotherapy (AC) after concurrent chemoradiotherapy (CCRT) could provide benefit to esophageal squamous cell carcinoma (ESCC) patients is controversial. Therefore, we decided to investigate the potential benefit of AC after CCRT for ESCC and to identify biomarkers predictive of a clinical benefit. Methods We retrospectively analysed the clinical data of ESCC patients with clinical stage II–IVa who underwent CCRT. Then, we compared patients who received CCRT and AC (CCRT + AC group) with those who received CCRT alone (CCRT group). Propensity score analysis, subgroup analysis and an additional Cox regression model were conducted to analyse the predictive factors. The overall survival (OS) and progression-free survival (PFS) rates were taken as the endpoints. Results From January 2013 to December 2017, 244 patients were recruited (n = 131 for CCRT + AC; n = 113 for CCRT alone) for the analysis. After propensity score matching was performed (1:1 and 99 patients for each group) with consideration of the basic clinical characteristics, no significant differences were found in OS (HR = 1.024; 95% CI 0.737–1.423; P = 0.886) or PFS (HR = 0.809; 95% CI 0.582–1.126; P = 0.197) between the two groups. The good short-term response subgroup showed a better PFS and favoured CCRT + AC treatment (HR = 0.542; 95% CI 0.336–0.876; P = 0.008), the independent predictive role of which was confirmed in additional multivariate Cox regression analysis. Conclusions Although AC did not significantly improve PFS and OS for all ESCC patients after CCRT, the short-term response to CCRT might help identify a subgroup that will benefit, which needs further prospective research to confirm.

scholarly journals Short-Term Response Might Influence The Treatment-Related Benefit of Adjuvant Chemotherapy After Concurrent Chemoradiotherapy for Esophageal Squamous Cell Carcinoma Patients

2021 ◽  
Author(s):  
Ao Liu ◽  
Yalin Wang ◽  
Zhongxing Zhao ◽  
Xiaotao Geng ◽  
Xin Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Concurrent Chemoradiotherapy ◽  
Cox Regression ◽  
Short Term ◽  
Term Response

Abstract Background Whether adjuvant chemotherapy (AC) after concurrent chemoradiotherapy (CCRT) could provide benefit to esophageal squamous cell carcinoma (ESCC) patients is controversial. Therefore, we decided to investigate the potential benefit of AC after CCRT for ESCC and to identify biomarkers predictive of a clinical benefit. Methods We retrospectively analysed the clinical data of ESCC patients with clinical stage II–IVa who underwent CCRT. Then, we compared patients who received CCRT and AC (CCRT + AC group) with those who received CCRT alone (CCRT group). Propensity score analysis, subgroup analysis and an additional Cox regression model were conducted to analyse the predictive factors. The overall survival (OS) and progression-free survival (PFS) rates were taken as the endpoints. Results From January 2013 to December 2017, 244 patients were recruited (n = 113 for CCRT + AC; n = 113 for CCRT alone) for the analysis. After propensity score matching was performed (1:1 and 99 patients for each group) with consideration of the basic clinical characteristics, no significant differences were found in OS (HR = 1.024; 95% CI, 0.737–1.423; P = 0.886) or PFS (HR = 0.809; 95% CI, 0.582–1.126; P = 0.197) between the two groups. The good short-term response subgroup showed a better PFS and favoured CCRT + AC treatment (HR = 0.542; 95% CI, 0.3356–0.8764; P = 0.008), the independent predictive role of which was confirmed in additional multivariate Cox regression analysis. Conclusions Although AC did not significantly improve PFS and OS for all ESCC patients after CCRT, the short-term response to CCRT might help identify a subgroup that will benefit, which needs further prospective research to confirm.

scholarly journals Single modality radical radiotherapy is an acceptable alternative for the older patient with squamous cell carcinoma of the oesophagus

2021 ◽  
Vol 8 (1) ◽  
pp. e000492
Author(s):  
Sarah Derby ◽  
Matthew Forshaw ◽  
Caroline Lowrie ◽  
Derek Grose ◽  
Husam Marashi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Multimodality Treatment ◽  
Radical Radiotherapy ◽  
Older Patient ◽  
Older Population ◽  
Cox Regression Analysis ◽  
Significant Difference

BackgroundOesophageal cancer remains a common cause of cancer mortality worldwide. Increasingly, oncology centres are treating an older population and comorbidities may preclude multimodality treatment with chemoradiotherapy (CRT). We review outcomes of radical radiotherapy (RT) in an older population treating squamous cell carcinoma (SCC) oesophagus.MethodsPatients over 65 years receiving RT for SCC oesophagus between 2013 and 2016 in the West of Scotland were identified. Kaplan-Meier and Cox-regression analysis were used to compare overall survival (OS) between patients treated with radical RT and radical CRT.ResultsThere were 83 patients over 65 years treated with either RT (n=21) or CRT (n=62). There was no significant difference in median OS between CRT versus RT (26.8 months vs 28.5 months, p=0.92). All patients receiving RT completed their treatment whereas 11% of CRT patients did not complete treatment.ConclusionSurvival in this non-trial older patient group managed with CRT is comparable to that reported in previous trials. RT shows better than expected outcomes which may reflect developments in RT technique. This review supports RT as an alternative in older patients, unfit for concurrent treatment.

scholarly journals Prognostic impact of lymph node metastasis along the left gastric artery in esophageal squamous cell carcinoma

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xuan Liu ◽  
Leilei Wu ◽  
Dongkun Zhang ◽  
Peng Lin ◽  
Hao Long ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Left Gastric Artery ◽  
Prognostic Impact ◽  
Gastric Artery ◽  
Term Survival

Abstract Background Although the incidence of lymph node (LN) metastasis (LNM) along the left gastric artery is high, its relationship with the prognosis in postoperative patients with esophageal squamous cell carcinoma (ESCC) is rarely reported. This study clarified the prognostic impact of LNM along the left gastric artery in postoperative patients with ESCC. Methods This study assessed data of 1521 patients with ESCC who underwent esophagectomy at the Sun Yat-sen University Cancer Center between March 1992 and March 2012. A chi-squared test and Mann-Whitney U test were used to explore the preliminary correlation between clinical factors and LNM along the left gastric artery. Univariate and multivariate Cox regression analyses were used to assess whether LNM along the left gastric artery was an independent predictor of overall survival. Kaplan–Meier analysis and the log-rank test were used to present a classifying effect based on LN status. Results LNM was observed in 598 patients (39.3%) and was found along the branches of the left gastric artery in 256 patients (16.8%). The patients were classified into two groups based on the presence of LNM along the left gastric artery. Patients without LNM along the left gastric artery had better cancer-specific survival than those with positive LNs (P <  0.001). Conclusions This study indicated that LNM along the left gastric artery was an important independent prognostic factor for long-term survival among ESCC patients (P = 0.011).

scholarly journals The preoperative HALP score (hemoglobin, albumin, lymphocyte and platelet) is a useful predictor in patients with resectable esophageal squamous cell carcinoma

2021 ◽  
Author(s):  
Ji-Feng Feng ◽  
Liang Wang ◽  
Xun Yang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prognostic Factor ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Roc Curve ◽  
Curative Resection ◽  
Cox Regression ◽  
Prognostic Score ◽  
Cancer Specific Survival

The hemoglobin, albumin, lymphocyte, and platelet (HALP) score has been confirmed as a prognostic factor in several types of cancers. The current study aimed to assess the prognostic value of preoperative HALP score, an inflammatory and nutritional based score, in predicting cancer-specific survival (CSS) in resectable patients undergoing curative resection for esophageal squamous cell carcinoma (ESCC). The clinical data of 355 consecutive patients with ESCC who underwent curative resection were retrospectively conducted and analyzed. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value for preoperative HALP. The areas under the curve (AUC) for preoperative HALP and other variables were calculated and compared. Cox regression analyses and Kaplan-Meier methods were used to identify the factors associated with CSS. According to the ROC curve, the optimal cut-off value for preoperative HALP was 31.8. The 5-year CSS for preoperative HALP low (≤31.8) and high (>31.8) was 15.1% and 47.5%, respectively (p<0.001). Preoperative HALP had reliable abilities to predict CSS in resectable ESCC patients in any stage or gender, according to the subgroup analysis based on the patients' cancer stage and gender. Multivariate analyses confirmed that preoperative HALP was an independent prognostic score regarding CSS in patients with resectable ESCC (p<0.001). This study confirmed that the preoperative HALP score could be regarded as a potential independent prognostic factor for CSS in patients with resectable ESCC.

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