Abstract
Background: This retrospective research, it was aimed to evaluate disease-free survival (DFS) using inflammatory markers in esophageal cancer patients who received chemoradiotherapy (CRT). Methods: A total of 67 patients who received standard curative chemoradiotherapy for esophageal cancer were included in the study between 2011-2018. The patient, treatment characteristics, and pretreatment inflammatory markers were obtained from the patient's file. Results : Median follow up time was 18 months (6-72 months). ROC curve analyses showed the C-Reactive Protein-to-Albumin (CAR) cut-off value 0.9 for DFS (AUC:78.8%; sensitivity: 85%; specificity; 67.5%). 2-year disease free survival for CAR ≥0.9 and CAR <0.9 were 45.7% and 78%, respectively ( P=0.035). The radiation doses >50Gy (versus <50Gy, p=0.027) and CAR ratio < 0.9 (versus ≥ 0.9, p=0.005) appeared significant associates of better DFS in univariate analyses, but the age, gender, stage, localization, neutrophil-to-lympocyte ratio (NLR) and platelet-to-lymhocyte ratio (PLR) were no statistically significant (p>0.005).On the multivariate logistic analysis, our results showed that CAR < 0.9 [hazard ratio (HR) 1.29; 95% confidence interval [CI], 1.336-2.946; P = 0.014]; and radiation dose >50 Gy (HR 0.91; 95% CI, 1.229-4.997; P = 0.027) independent prognostic indictors. Conclusion: Our study found that the C-Reactive Protein/Albumin ratio is easy to apply and maybe a promising marker to predict disease-free survival in esophageal cancer patients who received chemoradiotherapy.
Highlights
Esophageal cancer is constituting 1.5-2% of all cancers and 5-7% of digestive system cancers
The site of the tumor was located in the cervical region in 12 patients (16.9%) in the middle region in 20 patients (28.2%) and in the distal region in 35 patients (49.3%).CRT was applied to all patients
CAR of values and clinicopathological factors are compared in Table 2.Our study showed that higher radiation doses (≥50Gy vs.
Summary
Esophageal cancer is constituting 1.5-2% of all cancers and 5-7% of digestive system cancers. Treatment responses and survival are still different in locally advanced esophagus cancer patients. For this reason, many studies try to predict the treatment response and survival more accurately by adding to the staging system in biochemical and hematological parameters [3,4]. Many studies try to predict the treatment response and survival more accurately by adding to the staging system in biochemical and hematological parameters [3,4] These parameters that can be measured in the pre-treatment blood test and highly practical are most frequently used for survival estimation
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