Prediction Of Survival Of Patients With Non-Operative Intermediate And Advanced Esophageal Squamous Cell Carcinoma With Concurrent Chemoradiotherapy And D-Dimer Combined With Albumin Markers

Objective:To establish a new score system for predicting survival based on D-dimer and albumin levels,called DA score,for prognostic analysis of patients with advanced esophageal squamous cell carcinoma treated with concurrent chemoradiotherapy.Methods:D-dimer levels,albumin levels,peripheral blood cell levels and clinical characteristics of 146 patients with middle and advanced esophageal carcinoma squamous cell carcinoma receiving concurrent chemoradiotherapy in our hospital were collected 1week before treatment.Based on the analysis of the receiver operating characteristic curve,the optimal truncation value of D-dimer was 0.845μg/m L,and the optimal truncation value of albumin was 42.75 g/L.146 patients were divided into three groups:low D-dimer level(< 0.845μg/ml)and high albumin level(≥42.75 g/L)were rated as0;High D dimer level(≥0.845μg/ml)and high albumin level(≥42.75 g/L)or low D dimer level(< 0.845μg/ml)and low albumin level(< 42.75g/L)were rated as 1 score;High D-dimer level(≥0.845μg/ml)and low albumin level(< 0.845μg/ml)were rated as2 points.Results:1.The Overall Survival of patients with DA score of 2 was lower than that of patients with DA score of 1 and 0.1.The Overall Survival of patients with DA score of 2 was lower than that of patients with DA score of 1 and 0.Among them,the 1-year OS rate of patients with DA score 0 was 81.8%;The 1-year OS rate of patients with 1 score was 67.6%;The 1-year OS rate of patients with 2 scores was 41.9%(P =0.001);The 2-year OS rate of patients with DA score 0 was 40.9%;The 2-year OS rate of patients with 1 score was 29.6 percent,and the 2-year OS rate of patients with 2 score was 16.1 percent(P=0.001).2.Progression Free Survival of patients with high DA score was lower than patients with low DA score.The 1-year PFS rate of patients with 0 DA score was 65.9%.The1-year PFS rate of patients with 1 score was 54.9%;The 1-year PFS rate of patients with 2 scores was 29.0%(P = 0.001);The 2-year PFS rate of patients with DA score of 0 was 29.5%.The 2-year PFS rate of patients with 1 score was 25.4%;The 2-year PFS rate of patients with 2 points was and 6.6%(P=0.001).3.Cox univariate analysis showed that TNM stage,lesion location,lesion length,PLR and DA scores were significantly correlated with OS(P < 0.05).Lesion length,lesion location,TNM stage and DA score were significantly correlated with PFS(P< 0.05).However,Cox multivariate analysis showed that only DA score,lesion length and TNM clinical stage were significantly correlated with OS(P=0.002,P=0.003,P < 0.001).Similarly,multivariate Cox regression analysis showed that DA score,lesion length,and TNM clinical stage were significantly correlated with PFS(P=0.002,P=0.01,P < 0.001).Conclusions:DA score before concurrent chemoradiotherapy was significantly correlated with OS and PFS in patients with esophageal squamous cell carcinoma,and DA score could be used as an independent prognostic indicator of survival in ESCC patients with concurrent chemoradiotherapy.In addition,D-dimer and albumin are routinely measured and inexpensive in clinical practice.Therefore,DA score may be a valuable prognostic marker for ESCC patients with advanced chemoradiotherapy.