Advertisement

Modified Systemic Inflammation Score is Useful for Risk Stratification After Radical Resection of Squamous Cell Carcinoma of the Esophagus

  • Mitsuro KandaEmail author
  • Masahiko Koike
  • Chie Tanaka
  • Daisuke Kobayashi
  • Norifumi Hattori
  • Masamichi Hayashi
  • Suguru Yamada
  • Kenji Omae
  • Michitaka Fujiwara
  • Yasuhiro Kodera
Thoracic Oncology

Abstract

Background

Inflammation plays a critical role in the development and progression of cancers. We evaluated the clinical significance of the preoperative modified systemic inflammation score (mSIS) to predict long-term outcomes of patients with esophageal squamous cell carcinoma (ESCC).

Methods

We included 443 patients who underwent curative resection of ESCC. The mSIS was formulated according to the serum albumin level (ALB) and lymphocyte-to-monocyte ratio (LMR) as follows: mSIS 0 (ALB ≥ 4.0 g/dL and LMR ≥ 3.4), mSIS 1 (ALB < 4.0 g/dL or LMR < 3.4), and mSIS 2 (ALB < 4.0 g/dL and LMR < 3.4).

Results

Patients were categorized into preoperative mSIS 0 (n = 165), mSIS 1 (n = 183), and mSIS 2 (n = 95) groups. Preoperative mSIS was significantly associated with age, preoperative body mass index, and pathological disease stage. The disease-specific survival times of patients in preoperative mSIS 0, 1, and 2 sequentially shortened (P = 0.009), and mSIS 2 was identified as an independent prognostic factor (hazard ratio 2.63, 95% confidence interval 1.33–5.27, P = 0.0053). In most patient subgroups, the mSIS was associated with greater risk of disease-specific death. A stepwise increase in the prevalence of hematogenous recurrences was directly proportion to the mSIS. When patients were subdivided by mSIS before neoadjuvant treatment, there were no significant differences in disease-specific survival.

Conclusions

Our findings demonstrate that the preoperative mSIS may serve as a powerful prognosticator of ESCC that definitively stratifies clinical outcomes as well as a tool for selecting treatment strategies.

Notes

Acknowledgment

The authors thank Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

None.

Disclosure

None.

Supplementary material

10434_2019_7914_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 15 kb)
10434_2019_7914_MOESM2_ESM.tif (5.8 mb)
Supplementary material 2 (TIFF 5909 kb)

References

  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34.CrossRefGoogle Scholar
  2. 2.
    Domper Arnal MJ, Ferrandez Arenas A, Lanas Arbeloa A. Esophageal cancer: Risk factors, screening and endoscopic treatment in Western and Eastern countries. World J Gastroenterol. 2015;21:7933–43.CrossRefGoogle Scholar
  3. 3.
    Huang FL, Yu SJ. Esophageal cancer: Risk factors, genetic association, and treatment. Asian J Surg. 2016.Google Scholar
  4. 4.
    Lagergren J, Smyth E, Cunningham D, et al. Oesophageal cancer. Lancet. 2017;390:2383–96.CrossRefGoogle Scholar
  5. 5.
    Hong L, Han Y, Zhang H, et al. Prognostic markers in esophageal cancer: from basic research to clinical use. Expert Rev Gastroenterol Hepatol. 2015;9:887–9.CrossRefGoogle Scholar
  6. 6.
    Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature. 2008;454:436–44.CrossRefGoogle Scholar
  7. 7.
    Forssell J, Oberg A, Henriksson ML, et al. High macrophage infiltration along the tumor front correlates with improved survival in colon cancer. Clin Cancer Res. 2007;13:1472–9.CrossRefGoogle Scholar
  8. 8.
    Chang Y, An H, Xu L, et al. Systemic inflammation score predicts postoperative prognosis of patients with clear-cell renal cell carcinoma. Br J Cancer. 2015;113:626–33.CrossRefGoogle Scholar
  9. 9.
    Huang L, Liu S, Lei Y, et al. Systemic immune-inflammation index, thymidine phosphorylase and survival of localized gastric cancer patients after curative resection. Oncotarget. 2016;7:44185–93.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Sato B, Kanda M, Tanaka C, et al. Significance of Preoperative Systemic Inflammation Score in Short-Term and Long-Term Outcomes of Patients with Pathological T2-4 Gastric Cancer After Radical Gastrectomy. World J Surg. 2018;42:3277–85.CrossRefGoogle Scholar
  11. 11.
    Lin JX, Lin JP, Xie JW, et al. Prognostic importance of the preoperative modified systemic inflammation score for patients with gastric cancer. Gastric Cancer. 2019;22:403–12.CrossRefGoogle Scholar
  12. 12.
    Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74.CrossRefGoogle Scholar
  13. 13.
    Kanda M, Koike M, Tanaka C, et al. Risk Prediction of Postoperative Pneumonia After Subtotal Esophagectomy Based on Preoperative Serum Cholinesterase Concentrations. Ann Surg Oncol. 2019.Google Scholar
  14. 14.
    Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.CrossRefGoogle Scholar
  15. 15.
    Zhang D, Zheng Y, Wang Z, et al. Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for esophageal squamous cell carcinoma underwent radical surgery. Eur J Surg Oncol. 2017;43:1949–55.CrossRefGoogle Scholar
  16. 16.
    Kanda M, Mizuno A, Tanaka C, et al. Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer. Medicine (Baltimore). 2016;95:e3781.CrossRefGoogle Scholar
  17. 17.
    Zhang Y, Shi SM, Yang H, et al. Systemic inflammation score predicts survival in patients with intrahepatic cholangiocarcinoma undergoing curative resection. J Cancer. 2019;10:494–503.CrossRefGoogle Scholar
  18. 18.
    Chan JC, Chan DL, Diakos CI, et al. The Lymphocyte-to-Monocyte Ratio is a Superior Predictor of Overall Survival in Comparison to Established Biomarkers of Resectable Colorectal Cancer. Ann Surg. 2017;265:539–46.CrossRefGoogle Scholar
  19. 19.
    Leek RD, Lewis CE, Whitehouse R, et al. Association of macrophage infiltration with angiogenesis and prognosis in invasive breast carcinoma. Cancer Res. 1996;56:4625–9.PubMedGoogle Scholar
  20. 20.
    Pollard JW. Trophic macrophages in development and disease. Nat Rev Immunol. 2009;9:259–70.CrossRefGoogle Scholar
  21. 21.
    Shibutani M, Maeda K, Nagahara H, et al. The prognostic value of the systemic inflammatory score in patients with unresectable metastatic colorectal cancer. Oncol Lett. 2018;16:666–72.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Liu B, Huang Y, Sun Y, et al. Prognostic value of inflammation-based scores in patients with osteosarcoma. Sci Rep. 2016;6:39862.CrossRefGoogle Scholar
  23. 23.
    Geng Y, Shao Y, Zhu D, et al. Systemic Immune-Inflammation Index Predicts Prognosis of Patients with Esophageal Squamous Cell Carcinoma: A Propensity Score-matched Analysis. Sci Rep. 2016;6:39482.CrossRefGoogle Scholar
  24. 24.
    Inaoka K, Kanda M, Uda H, et al. Clinical utility of the platelet-lymphocyte ratio as a predictor of postoperative complications after radical gastrectomy for clinical T2-4 gastric cancer. World J Gastroenterol. 2017;23:2519–26.CrossRefGoogle Scholar
  25. 25.
    Sasahara M, Kanda M, Ito S, et al. The Preoperative Prognostic Nutritional Index Predicts Short-Term and Long-Term Outcomes of Patients with Stage II/III Gastric Cancer: Analysis of a Multi-Institution Dataset. Dig Surg. 2019:1–10.Google Scholar
  26. 26.
    Suzuki Y, Okabayashi K, Hasegawa H, et al. Comparison of Preoperative Inflammation-based Prognostic Scores in Patients With Colorectal Cancer. Ann Surg. 2016.Google Scholar
  27. 27.
    Ryo S, Kanda M, Ito S, et al. The Controlling Nutritional Status Score Serves as a Predictor of Short- and Long-Term Outcomes for Patients with Stage 2 or 3 Gastric Cancer: Analysis of a Multi-institutional Data Set. Ann Surg Oncol. 2019;26:456–64.CrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Mitsuro Kanda
    • 1
    Email author
  • Masahiko Koike
    • 1
  • Chie Tanaka
    • 1
  • Daisuke Kobayashi
    • 1
  • Norifumi Hattori
    • 1
  • Masamichi Hayashi
    • 1
  • Suguru Yamada
    • 1
  • Kenji Omae
    • 2
  • Michitaka Fujiwara
    • 1
  • Yasuhiro Kodera
    • 1
  1. 1.Department of Gastroenterological Surgery (Surgery II)Nagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of Innovative Research and Education for Clinicians and Trainees (DiRECT)Fukushima Medical University HospitalFukushimaJapan

Personalised recommendations