title: Comparison of the prognostic values of various nutritional parameters in patients with esophageal squamous cell carcinoma from Southern China.
abstract: BACKGROUND
  Nutritional evaluation is important for patients with esophageal cancer, but the impact of undernutrition on outcome of those patients is not well elucidated. Our aim is to assess the impact of baseline nutritional status on overall survival (OS) in Chinese patients with esophageal squamous cell carcinoma (ESCC) and to detect a most appropriate indicator for nutritional evaluation.
  
  
  METHODS
  502 patients from Southern China diagnosed as ESCC in Sun Yat-Sen University Cancer Center were included. A series of nutritional indicators were introduced to evaluate the baseline nutritional status. Kaplan-Meier method was used to estimate the 5-year OS and the log-rank test was used to determine the survival differences. Cox proportional hazards model was used in the univariate and multivariate analyses of OS.
  
  
  RESULTS
  With a median follow up time of 30 months, the median OS for the entire patient group was 37.3 months with the 5-year OS rate of 43.0%. Only performance status, AJCC 6th stage and body mass index (BMI) were the independent prognostic factors in multivariate analysis of OS. The median OS for patients with BMI less than 18.5, patients with BMI within 18.5-24.9 and patients with BMI more than 24.9 were 19.2, 43.2 and 51.6 months, respectively, with the 5-year OS rates of 25.2%, 46.1% and 48.1% (P<0.001). Patients with BMI <18.5 tended to present with a more advanced stage disease and a poorer tumor grade.
  
  
  CONCLUSIONS
  Baseline nutritional status is predictive of OS in Chinese patients with ESCC. BMI is a steady indicator for nutritional evaluation and a sensitive prognostic parameter for ESCC patients. Treatment optimization in ESCC patients with low BMI should integrate the modalities and individual nutritional support.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou 510060, P. R. China; ; Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, P. R. China;
authors.forename: Peng
authors.initials: P
authors.lastname: Sun
authors.forename: Fei
authors.initials: F
authors.lastname: Zhang
authors.forename: Cui
authors.initials: C
authors.lastname: Chen
authors.forename: Xin
authors.initials: X
authors.lastname: An
authors.forename: Yu-Hong
authors.initials: YH
authors.lastname: Li
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Wang
authors.forename: Zhi-Hua
authors.initials: ZH
authors.lastname: Zhu
keywords: Nutritional parameters; body mass index (BMI); esophageal squamous cell carcinoma; prognostic value