Prognostic value of inflammatory nutritional scores in locally advanced esophageal squamous cell carcinoma patients undergoing neoadjuvant chemoimmunotherapy: a multicenter study in China

Jinxin Xu; Zhinuan Hong; Yingjie Cai; Zhen Chen; Jingping Lin; Xi Yuan; Shuchen Chen; Jinbiao Xie; Mingqiang Kang; Sunkui Ke

doi:10.3389/fonc.2024.1279733

Prognostic value of inflammatory nutritional scores in locally advanced esophageal squamous cell carcinoma patients undergoing neoadjuvant chemoimmunotherapy: a multicenter study in China

Front Oncol. 2024 Feb 15:14:1279733. doi: 10.3389/fonc.2024.1279733. eCollection 2024.

Authors

Jinxin Xu^#^{1

2}, Zhinuan Hong^#^{3

4

5

6}, Yingjie Cai^#^{1

2}, Zhen Chen^#^{7

8}, Jingping Lin^#⁹, Xi Yuan¹⁰, Shuchen Chen^{3

4

5

6}, Jinbiao Xie⁷, Mingqiang Kang^{3

4

5

6}, Sunkui Ke^{1

2}

Affiliations

¹ Department of Thoracic Surgery, Zhongshan Hospital Xiamen University, Xiamen, China.
² Fujian Medical University, Fuzhou, China.
³ Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
⁴ Key Laboratory of Cardio-Thoracic Surgery(Fujian Medical University), Fujian Province University, Fuzhou, China.
⁵ Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.
⁶ Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China.
⁷ Department of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian, China.
⁸ Department of Cardiothoracic Surgery, Putian Pulmonary Hospital, Putian, China.
⁹ The First Affiliated Hospital of Xiamen University, Xiamen, China.
¹⁰ Fujian Rongcheng Judicial Compulsory Isolation Drug Rehabilitation Center, Fuzhou, China.

^# Contributed equally.

Abstract

Objective: This study investigates the prognostic significance of inflammatory nutritional scores in patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC) undergoing neoadjuvant chemoimmunotherapy.

Methods: A total of 190 LA-ESCC patients were recruited from three medical centers across China. Pre-treatment laboratory tests were utilized to calculate inflammatory nutritional scores. LASSO regression and multivariate logistic regression analyses were conducted to pinpoint predictors of pathological response. Kaplan-Meier and Cox regression analyses were employed to assess disease-free survival (DFS) prognostic factors.

Results: The cohort comprised 154 males (81.05%) and 36 females (18.95%), with a median age of 61.4 years. Pathological complete response (pCR) was achieved in 17.38% of patients, while 44.78% attained major pathological response (MPR). LASSO and multivariate logistic regression analyses identified that hemoglobin, albumin, lymphocyte, and platelet (HALP) (P=0.02) as an independent predictors of MPR in LA-ESCC patients receiving neoadjuvant chemoimmunotherapy. Kaplan-Meier and log-rank tests indicated that patients with low HALP, MPR, ypT1-2, ypN0 and, ypTNM I stages had prolonged DFS (P < 0.05). Furthermore, univariate and multivariate Cox regression analyses underscored HALP (P = 0.019) and ypT (P = 0.029) as independent predictive factors for DFS in ESCC.

Conclusion: Our study suggests that LA-ESCC patients with lower pre-treatment HALP scores exhibit improved pathological response and reduced recurrence rate. As a comprehensive index of inflammatory nutritional status, pre-treatment HALP may be a reliable prognostic marker in ESCC patients undergoing neoadjuvant chemoimmunotherapy.

Keywords: disease-free survival; esophageal squamous cell carcinoma; hemoglobin, albumin, lymphocyte, and platelet; inflammatory nutritional scores; major pathological response; neoadjuvant chemoimmunotherapy.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the projects of Xiamen Science and Technology Commission (3502Z20209028).