内容紹介
The Impact of Neutrophil-Lymphocyte Ratio on the Prognosis in Patients Who Underwent Esophagectomy for Esophageal Cancer
Summary
Background: The neutrophil-lymphocyte ratio(NLR)reflects a patient's systemic inflammatory response. Several studies have revealed that the NLR is associated with a poor prognosis in several types of malignant tumors such as colorectal and lung cancer. The aim of this study was to evaluate the impact of preoperative NLR on the prognosis of patients with esophageal cancer. Methods: The NLR was calculated for 93 consecutive patients with clinical StageⅡ or Ⅲ esophageal cancer, who underwent curative esophagectomy following neoadjuvant chemotherapy between 2011 and 2013. The impact of preoperative NLR on overall survival(OS)after esophagectomy was evaluated. The NLR cut off value was set to 2. Results: The 3-year OS of patients with NLR≥2 was significantly shorter than patients with NLR<2(40.5% vs 67.9%, p=0.005). In a multivariate Cox model, NLR≥2(HR: 2.342, 95%CI: 1.095-5.007, p=0.028), pathological depth of tumor(HR: 3.207, 95%CI: 1.114-9.233, p=0.031), and an age over 60(HR: 2.342, 95%CI: 1.117-6.501, p=0.027)were identified as independent prognostic factors for OS after esophagectomy. Conclusions: The preoperative NLR was significantly associated with a poor prognosis in esophageal cancer patients who underwent curative esophagectomy following neoadjuvant chemotherapy.
要旨
緒言: 好中球リンパ球比(neutrophil-lymphocyte ratio: NLR)は種々の癌腫において予後不良因子であることが報告されている。今回われわれは,術前化学療法を施行したcStageⅡ/Ⅲ食道癌根治切除症例におけるNLRと予後との関連を検討した。対象と方法: 2011～2013年までの間にcStageⅡ/Ⅲ食道癌に対して術前化学療法としてFP療法を2コース施行後に食道亜全摘術,3領域郭清を施行し,R0手術が得られた93例を対象とした。手術直前のNLRを算出し,予後(全生存率: OS)との関連を後方視的に解析した。NLRのcut off値は2とした。結果: NLR≧2(n=37)とNLR<2(n=56)の3年OSはそれぞれ40.5%,67.9%(p=0.005)と有意差を認め,多変量解析では,60歳以上(HR: 2.342,95%CI: 1.117-6.501,p=0.027),pT≧3(HR: 3.207,95%CI: 1.114-9.233,p=0.031),NLR≧2(HR: 2.342,95%CI: 1.095-5.007,p=0.028)が独立した予後不良因子であった。結語: 術前化学療法を施行した食道癌手術症例において術前NLRは予後不良因子であることが示唆された。
目次
Summary
Background: The neutrophil-lymphocyte ratio(NLR)reflects a patient's systemic inflammatory response. Several studies have revealed that the NLR is associated with a poor prognosis in several types of malignant tumors such as colorectal and lung cancer. The aim of this study was to evaluate the impact of preoperative NLR on the prognosis of patients with esophageal cancer. Methods: The NLR was calculated for 93 consecutive patients with clinical StageⅡ or Ⅲ esophageal cancer, who underwent curative esophagectomy following neoadjuvant chemotherapy between 2011 and 2013. The impact of preoperative NLR on overall survival(OS)after esophagectomy was evaluated. The NLR cut off value was set to 2. Results: The 3-year OS of patients with NLR≥2 was significantly shorter than patients with NLR<2(40.5% vs 67.9%, p=0.005). In a multivariate Cox model, NLR≥2(HR: 2.342, 95%CI: 1.095-5.007, p=0.028), pathological depth of tumor(HR: 3.207, 95%CI: 1.114-9.233, p=0.031), and an age over 60(HR: 2.342, 95%CI: 1.117-6.501, p=0.027)were identified as independent prognostic factors for OS after esophagectomy. Conclusions: The preoperative NLR was significantly associated with a poor prognosis in esophageal cancer patients who underwent curative esophagectomy following neoadjuvant chemotherapy.
要旨
緒言: 好中球リンパ球比(neutrophil-lymphocyte ratio: NLR)は種々の癌腫において予後不良因子であることが報告されている。今回われわれは,術前化学療法を施行したcStageⅡ/Ⅲ食道癌根治切除症例におけるNLRと予後との関連を検討した。対象と方法: 2011～2013年までの間にcStageⅡ/Ⅲ食道癌に対して術前化学療法としてFP療法を2コース施行後に食道亜全摘術,3領域郭清を施行し,R0手術が得られた93例を対象とした。手術直前のNLRを算出し,予後(全生存率: OS)との関連を後方視的に解析した。NLRのcut off値は2とした。結果: NLR≧2(n=37)とNLR<2(n=56)の3年OSはそれぞれ40.5%,67.9%(p=0.005)と有意差を認め,多変量解析では,60歳以上(HR: 2.342,95%CI: 1.117-6.501,p=0.027),pT≧3(HR: 3.207,95%CI: 1.114-9.233,p=0.031),NLR≧2(HR: 2.342,95%CI: 1.095-5.007,p=0.028)が独立した予後不良因子であった。結語: 術前化学療法を施行した食道癌手術症例において術前NLRは予後不良因子であることが示唆された。