| Background:The objective of this study was to investigate the prognostic value of peripheral blood monocytes in esophageal squamous cell carcinoma (ESCC) patients who underwent esophagectomy.Methods:Records from 218 consecutive patients with histologically diagnosed ESCC who underwent esophagectomy at Qilu Hospital of Shandong University from January 2007 to December 2008 were retrospectively reviewed.Results:1. The overall median (range) white blood cell, absolute neutrophil count, absolute lymphocyte count, absolute monocyte count, and absolute platelet count in our cohort were 6.415(3.23-13.20)×109/L,4.015(1.62-10.13)×109/L,1.655 (0.39-4.04)×109/L,0.460(0.18-1.07)×109/L and 240(78-652)×109/L, respectively.2. The cut-off value of 0.42×109/L for the absolute monocyte count (AMC) was chosen as optimal to discriminate between survival and death by applying receiver operating curve analysis. There were 131 patients (60.1%) who had high AMC (≥0.42 x 109/L) preoperatively.3. We found that AMC was significantly associated with gender, tumor location, and platelet count. Kaplan-Meier survival analysis of patients with high preoperative AMC had a significant worse prognosis for DFS (high vs. low:27.5% vs.39.0%, P= 0.015) and OS (high vs. low:31.1% vs.44.8%, P=0.009) than those with low preoperative AMC. In a multivariate analysis, preoperative AMC was an independent prognostic factor for DFS (P=0.025, hazard ratio[HR]:1.469,95% confidence interval [CI]:1.050-2.054) and OS (P=0.015, HR:1.547,95% CI:1.088-2.200). In addition, among 140 patients without both preoperative and postoperative therapy, significantly worse OS (P=0.012) and marginally reduced DFS (P=0.079) were found in the high AMC cohort versus the low AMC cohort.Conclusions:A higher preoperative absolute peripheral monocyte count can be considered as a useful prognostic marker of ESCC patients who underwent esophagectomy.Background:The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio(PLR) could predict the prognosis of ESCC patients who underwent esophagectomy.Methods:Records from all patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models.Results:1. Among the 218 patients,41 (18.8%) were women and 177 (81.2%) were men. The median age of the entire cohort at the time of diagnosis was 60.5 years (range 32-84 years). The median follow-up was 38.6 months (range 3-71months).2. The cut-off value of 2.57 for the LMR,2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Based on the cutoff value of LMR,45 patients were included in the low LMR group (<2.57), whereas the other 173 patients were in the high LMR group (^ 2.57). The incidence of locoregional recurrences among patients with low LMR was 57.8%, significantly higher than those with high LMR (40.5%) (p=0.037).3. Kaplan-Meier survival analysis of patients with low preoperative LMR had a significant worse prognosis for DFS (P=0.004) and OS (P=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (P=0.004) and OS (P=0.011). Marginally reduced DFS (P=0.068) and lower OS (P=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (P=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (P=0.004, HR=1.759,95% CI 1.201-2.576) in ESCC patients.Conclusions:Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC who underwent esophagectomy.Background:It is now widely accepted that cancer patients survival is determined not only by tumor pathology but also by host factors, such as the preoperative nutritional and immunological status. Prognostic nutritional index (PNI), based on serum albumin level and total lymphocyte count, was originally proposed to assess perioperative immunonutritional status and risk of gastrointestinal surgical. In the last decades, PNI has been proved to be an independent preoperative prognostic indicator in various tumors, especially in gastrointestinal carcinomas. Our previous study found that the lymphocyte-monocyte ration (LMR) was a better prognostic factor compared with the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) in esophageal squamous cell carcinoma (ESCC) patients undergoing esophagectomy. Thus, systemic inflammation score (SIS), a novel prognostic score consisted of serum albumin and LMR, may be a better predictive factor for postoperative clinical outcome in malignancies.The objective of this study was to investigate the clinical significance of SIS and PNI in ESCC patients who underwent esophagectomy.Methods:Records from patients with histologically diagnosed ESCC who underwent esophagectomy at Qilu Hospital of Shandong University from January 2007 to December 2008 were retrospectively reviewed. Patients were excluded if they underwent neoadjuvant therapy, with obvious infections or autoimmune disease, lost to follow up and without preoperative albumin records.Results:1. The median disease-free survival (DFS) of this cohort was 32.3 months and 5-year DFS was 34.5%. The median overall survival (OS) was 39.5 months and 5-year OS was 40.8%.2. We found that high SIS was significantly associated with increased tumor length (p=0.021), increased depth of invasion (p=0.001), lymph node metastasis (p=0.038) and advanced pathological stage (p=0.004). Significant differences were identified regarding tumor length (p= 0.002), N stage (p= 0.001) and TNM stage (p = 0.002) between the low PNI group and high PNI group.3. Kaplan-Meier survival analysis revealed that both high SIS and low PNI were significantly associated with inferior DFS (for the SIS:p=0.005; for the PNI: p=0.003) and OS (for the SIS:p=0.007; for the PNI:p=0.002). In multivariate analysis, SIS was an independent prognostic indicator for both DFS and OS. However, PNI was not an independent prognosticator in multivariate analysis.Conclusions:SIS was a novel and promising inflammation-based prognostic score than PNI in ESCC patients who underwent esophagectomy. |
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