Prognostic significance of platelet × C-reactive protein multiplier in patients with esophageal squamous cell carcinoma.

Abstract

The prognostic significance of the peripheral platelet count × serum C-reactive protein level multiplier (P-CRP) has not been widely studied in patients with esophageal squamous cell carcinoma (ESCC). We retrospectively analyzed data from 116 thoracic ESCC patients who underwent curative esophagectomy. The patients were divided into the P-CRPHigh ( > 1.674) and P-CRPLow ( ≤ 1.674) groups, according to a cut-off value determined by a receiver operator curve. The 5-year overall survival (OS) rates significantly differed between the groups (P-CRPHigh: 46.4% and P-CRPLow: 77.3%; P = 0.0056). In the multivariate analysis, the P-CRP was an independent prognostic factor. We also evaluated the survival in the subgroup of patients who received neoadjuvant chemotherapy (NAC; n = 49). Among 28 patients who were P-CRPHigh before NAC, 20 remained. P-CRPHigh after NAC, while eight became post-P-CRPLow. Among 21 patients who were P-CRPLow before NAC, 16 remained post-P-CRPLow after NAC, while five became post-P-CRPHigh. The 5-year OS rate for patients who were P-CRPLow both before and after NAC was 92.9%, compared with 30.2% in other patients (P = 0.0034). In the multivariate analysis, the combination of P-CRP + post-P-CRP was an independent prognostic factor in ESCC patients who underwent NAC. The P-CRP is useful for predicting the prognosis in ESCC patients.