title: A new inflammation index is useful for patients with esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The prognostic value of inflammation indexes in esophageal cancer has not been established. Recent studies have shown that the advanced lung cancer inflammation index (ALI) is a useful predictive factor. The purpose of the current study was to determine whether the ALI is useful for predicting long-term survival in patients with esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  A total of 293 patients who had undergone esophagectomy for ESCC were included. The ALI was calculated as body mass index × serum albumin/neutrophil-to-lymphocyte ratio. Then, patients were divided into two groups: ALI ≥18 and ALI <18. The Kaplan-Meier method was used to calculate the cancer-specific survival (CSS), and the difference was assessed by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic factors.
  
  
  RESULTS
  In our study, there were 120 patients with ALI <18 and 173 patients with ALI ≥18. ALI was significantly higher in patients with large tumors (P=0.028), poor differentiation (P=0.010), deep invasion (P=0.009), and nodal metastasis (P=0.004). The 5-year CSS was 34.5% in our study. Patients with ALI <18 had a significantly poorer 5-year CSS compared to ALI ≥18 (21.7% versus 43.4%, P<0.001). On multivariate analysis, we showed that the ALI was a significant predictive factor of CSS (P=0.024).
  
  
  CONCLUSIONS
  The ALI is still a useful predictive factor for long-term CSS in patients with ESCC. However, the prognostic value of the ALI is yet to be formally tested within randomized trials.
authors.affiliation: Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
authors.forename: Ji-Feng
authors.initials: JF
authors.lastname: Feng
authors.affiliation: Department of Operating Theater, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China.
authors.forename: Qi Xun
authors.initials: QX
authors.lastname: Chen
keywords: albumin; body mass index; esophageal squamous cell carcinoma; neutrophil-to-lymphocyte ratio; survival