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Lymphocyte-to-C-Reactive Protein Ratio as a Novel Marker for Predicting Oncological Outcomes in Patients with Esophageal Cancer

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Abstract

Background

Esophageal cancer has a poor prognosis because of its rapid progression and early and extensive lymph node metastasis. Simple, objective indicators for predicting long-term outcomes are needed to select optimal perioperative treatment and appropriate follow-up for patients with esophageal cancer. The aim of this study is to investigate the relationship between the lymphocyte-to-C-reactive protein ratio (LCR) and the survival of patients with esophageal cancer, by performing time-dependent receiver operating characteristic (ROC) curve analysis. The results were compared to those of traditional inflammation-based markers.

Methods

This study enrolled 495 patients who underwent thoracic esophagectomy for esophageal cancer as the primary treatment between 2000 and 2019 in our department. We investigated the predictability of the LCR for oncological outcomes compared to that of other traditional inflammatory markers.

Results

The 3-year overall survival (OS) and recurrence-free survival (RFS) were 72.6% and 57.5%, respectively. Low LCR was significantly associated with higher cancer stage, included depth of invasion (p < 0.001), lymph node metastasis (p < 0.001) and cStage (p < 0.001). The LCR had the highest AUC value (0.675) for predicting OS compared to the other examined inflammatory markers. In multivariate analysis, the LCR (optimal cutoff threshold = 19,000) was identified as a significant predictor of death (hazard ratio, 2.24; 95% confidence interval [CI], 1.61–3.12; p < 0.001) and recurrence (hazard ratio, 1.97; 95%CI, 1.48–2.63; p < 0.001).

Conclusion

The LCR is novel indicator for oncological outcomes for patients with esophageal cancer and may assist to facilitate personalized multidisciplinary treatments.

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Acknowledgements

We wish to thank Kumiko Motooka, a staff member at the Department of Surgery in Keio University School of Medicine, for her help with the preparation of this manuscript.

Funding

No funding was obtained for this study.

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Authors and Affiliations

  1. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Masashi Takeuchi, Hirofumi Kawakubo, Shota Hoshino, Satoru Matsuda, Shuhei Mayanagi, Tomoyuki Irino, Kazumasa Fukuda, Rieko Nakamura, Norihito Wada & Yuko Kitagawa

Authors
  1. Masashi Takeuchi
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  2. Hirofumi Kawakubo
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  3. Shota Hoshino
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  4. Satoru Matsuda
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  5. Shuhei Mayanagi
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  6. Tomoyuki Irino
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  7. Kazumasa Fukuda
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  8. Rieko Nakamura
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  9. Norihito Wada
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  10. Yuko Kitagawa
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Corresponding author

Correspondence to Hirofumi Kawakubo.

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Conflicts of interest

Y.K. received lecture fees from Chugai Pharmaceutical Co., Ltd., Taiho Pharmaceutical Co., Ltd, Asahi Kasei Pharma Corporation, Otsuka Pharmaceutical Factory Inc., Shionogi & Co., Ltd., Nippon Covidien Inc., Ono Pharmaceutical Co., Ltd. and Bristol-Myers Squibb K.K. Y.K. was supported by grants from Chugai Pharmaceutical Co., Ltd., Taiho Pharmaceutical Co., Ltd, Yakult Honsha Co. Ltd., Asahi KASEI Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Tsumura & CO., Kyouwa Hakkou Kirin Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., EA Pharma Co., Ltd., Astellas Pharma Inc., Toyama Chemical Co., Ltd., Medicon Inc., Kaken Pharmaceutical Co. Ltd., Eisai Co., Ltd., Otsuka Pharmaceutical Factory Inc., Teijin Pharma Limited., Nihon Pharmaceutical Co., Ltd. and Nippon Covidien Inc. Y.K. also holds an endowed chair provided by Chugai Pharmaceutical Co., Ltd. and Taiho Pharmaceutical Co., Ltd., outside the submitted work.

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Takeuchi, M., Kawakubo, H., Hoshino, S. et al. Lymphocyte-to-C-Reactive Protein Ratio as a Novel Marker for Predicting Oncological Outcomes in Patients with Esophageal Cancer. World J Surg 45, 3370–3377 (2021). https://doi.org/10.1007/s00268-021-06269-z

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