Abstract
This prospective study was designed to investigate the prognosis of preoperative blood-routine markers for esophageal cancer mortality by using data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. Patients who received three-field lymphadenectomy for esophageal cancer between 2000 and 2010 were enrolled. Of 2535 patients with complete survival data, esophageal squamous cell carcinoma (ESCC) accounted for 94.5% (n = 2396). Here, only ESCC patients were analyzed, with the median follow-up time of 38.2 months (range: 0.5 to 180 months). Of 10 blood-routine markers evaluated, platelet count and red cell distribution width (RDW) were two significant predictors for ESCC mortality in men (adjusted hazard ratio or HR = 1.25 and 0.84, 95% confidence interval or CI: 1.08-1.22 and 0.75-0.93, P < 0.001 and P = 0.001, respectively), while in women only lymphocyte showed marginal significance. Based on individual results, a new derivate calculated as platelet count to RDW ratio (PRR) was created, and it was superior over other widely-evaluated derivates in men after adjustment (HR = 1.21, 95% CI: 1.13-1.30, P < 0.001), while there was no observable significance in women. In further stratified analyses, the prognosis of PRR for ESCC mortality was reinforced in men with tumor-node-metastasis stage III (HR, 95% CI, P: 1.18, 1.09-1.28, 0.001), invasion depth T3-T4 (1.17, 1.08-1.26, <0.001) or positive lymph node metastasis (1.37, 1.18-1.59, <0.001). Taken together, we created a new derivate PRR that was proven to be superior over other blood-routine markers and exhibited strong prognostic capability for ESCC mortality in Chinese men.
Highlights
Esophageal cancer ranks as the 4th most frequent cancer in China, as projected by the latest national statistics reporting a large proportion in cancer-related incidence (11.1%) and mortality (13.3%) in 2015 [1]
The most noteworthy finding of this prospective study was that we created a new derivate platelet count to RDW ratio (PRR) that was superior over other blood-routine markers and exhibited strong prognostic capability for Esophageal squamous cell carcinoma (ESCC) mortality in Chinese men
To the authors’ knowledge, this is so far the www.impactjournals.com/oncotarget largest prospective study of 2396 ESCC patients with a median follow-up of 38.2 months that has investigated the prognosis of preoperative blood-routine markers for esophageal cancer mortality in medical literature
Summary
Esophageal cancer ranks as the 4th most frequent cancer in China, as projected by the latest national statistics reporting a large proportion in cancer-related incidence (11.1%) and mortality (13.3%) in 2015 [1]. It is estimated that distant metastasis rate was 20-30% in esophageal cancer patients at the time of initial diagnosis [3]. Esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) constitute two major histological types of esophageal cancer. More concerning is their epidemiologic disproportionation, as compared with the most prevalent EAC in many Western countries, ESCC is predominant in Chinese, accounting for over 90% of esophageal cancer cases [4, 5]. Despite the dramatic advancements made in cancer management, the 5-year overall survival rate of esophageal cancer is around 20% in China, highlighting a urgent need to seek effective biomarkers with prognostic significance to guide treatment [6, 7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
