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. 2018 Jan;42(1):172-184.
doi: 10.1007/s00268-017-4144-y.

A Novel Prognostic Scoring System Using Inflammatory Response Biomarkers for Esophageal Squamous Cell Carcinoma

Noriyuki Hirahara  1 , Yoshitsugu Tajima  2 , Yusuke Fujii  2 , Tetsu Yamamoto  2 , Ryoji Hyakudomi  2 , Takanori Hirayama  2 , Takahito Taniura  2 , Kazunari Ishitobi  2 , Akihiko Kidani  2 , Yasunari Kawabata  2
Affiliations

A Novel Prognostic Scoring System Using Inflammatory Response Biomarkers for Esophageal Squamous Cell Carcinoma

Noriyuki Hirahara et al. World J Surg. 2018 Jan.

Abstract

Background: We describe a novel scoring system, namely the inflammatory response biomarker (IRB) score. The aim of this study is to evaluate the clinical value of IRB score in patients undergoing curative resection for esophageal squamous cell carcinoma (SCC).

Methods: We retrospectively reviewed patients who underwent curative esophagectomy. We evaluated IRB score in both non-elderly (<70 years) and elderly (≥70 years) SCC patients. The IRB score was determined as follows: a high lymphocyte-to-monocyte ratio (LMR) (>4), a high neutrophil-to-lymphocyte ratio (NLR) (>1.6), and a low platelet-to-lymphocyte ratio (PLR) (<147) were each scored as 1, and the remaining values were scored as 0; the individual scores were then summed to produce the IRB score (range 0-3).

Results: Univariate analyses demonstrated that the TNM pStage (p < 0.0001), tumor size (p = 0.002), LMR (p = 0.0057), PLR (p = 0.0328) and IRB score (p = 0.0003) were significant risk factors for a worse prognosis. On multivariate analysis, the TNM pStage (p < 0.0001) and IRB score (p = 0.0227) were independently associated with worse prognosis in overall patients. Among non-elderly patients, multivariate analyses demonstrated that the pStage (p = 0.0015) and IRB score (p = 0.0356) were independent risk factors for a worse prognosis. Among elderly patients, multivariate analysis demonstrated that the pStage (p = 0.0016), and IRB score (p = 0.0102) were independent risk factors for a worse prognosis.

Conclusion: The present study provides evidence that the preoperative IRB score can be considered a promising independent prognostic factor of cancer-specific survival in patients undergoing curative resection for SCC, and that its predictive ability is useful in both non-elderly and elderly patients.

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Conflict of interest statement

Conflict of interest

Noriyuki Hirahara, Yoshitsugu Tajima, Yusuke Fujii, Tetsu Yamamoto, Ryoji Hyakudomi, Takanori Hirayama, Takahito Taniura, Kazunari Ishitobi, Akihiko Kidani, and Yasunari Kawabata declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Flow diagram of this study
Fig. 2
Fig. 2
Kaplan–Meier survival curves showing the relationship between inflammatory response biomarkers and CSS after esophagectomy in overall patents with esophageal cancer. a LMR, b PLR, c NLR
Fig. 3
Fig. 3
Kaplan–Meier survival curves showing the relationship between IRB score and CSS after esophagectomy in overall patents with esophageal cancer
Fig. 4
Fig. 4
Kaplan–Meier survival curves showing the relationship between IRB score and CSS after esophagectomy in non-elderly patents with esophageal cancer
Fig. 5
Fig. 5
Kaplan–Meier survival curves showing the relationship between IRB score and CSS after esophagectomy in elderly patents with esophageal cancer
See this image and copyright information in PMC

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