Abstract
Objective: Cancer-associated systemic inflammation response and hyperfibrinogenemia play crucial roles in cancer progression and prognosis. In the present study, we assessed the clinical value of the preoperative fibrinogen and the neutrophil to lymphocyte ratio (NLR) in patients with esophageal squamous cell carcinoma (ESCC) and adenocarcinoma of the esophagogastric junction (AEG).Methods: Three hundred and fifty-six patients who underwent curative surgery were retrospectively analyzed. Univariate and Multivariate Cox analyses were performed to evaluate the prognostic indicators for overall survival (OS). The optimization cut-off values for fibrinogen and the NLR were 3.09 g/l and 1.89, respectively. The fibrinogen and the NLR (F-NLR) index was 2 for patients with high fibrinogen (≥3.09 g/l) and elevated NLR (≥1.89), whereas those with one or neither were indexed as 1 or 0, respectively.Results: The F-NLR score was significantly associated with tumor size (P<0.001), and pathological stage (P=0.010). The 5-year OS rates in F-NLR groups 0, 1 and 2 were 69.1, 42.6, and 31.9%, respectively (P<0.001). Multivariate analysis showed that the tumor size (P<0.001), pathological stage (P<0.001), and F-NLR (P<0.001) were independent prognostic factors for OS. Conclusions: The preoperative F-NLR score is an independent prognosis indicator for patients with ESCC and AEG.
Highlights
Esophageal cancer is one of the common aggressive malignant tumors, with a high ratio of tumor recurrence and mortality [1], esophageal squamous cell carcinoma (ESCC) occupies major portion [2]
A total of 356 patients who were pathologically diagnosed as ESCC or Adenocarcinoma of the esophagogastric junction (AEG) were included in this retrospective analysis (Table 1)
Patients were categorized into three independent groups as follows: fibrinogen and the neutrophil to lymphocyte ratio (NLR) (F-NLR) = 0, 95 (26.7%) patients; F-NLR = 1, 145 (40.7%) patients; and F-NLR = 2, 116 (32.6%) patients
Summary
Esophageal cancer is one of the common aggressive malignant tumors, with a high ratio of tumor recurrence and mortality [1], esophageal squamous cell carcinoma (ESCC) occupies major portion [2]. Adenocarcinoma of the esophagogastric junction (AEG), is a representative malignancy located between the esophagus and stomach, and was originally characterized by Siewert [3]. It was well-known to have unique clinicopathological features and biological behavior. It is important to search suitable clinical prognostic factors to supply more accurate and precise evaluates of survival, extremely important in high-fatality malignancies. This can both enhance outcomes and decrease costs by better choosing patients for eligible treatment [6]
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