title: Impact of inflammation-based prognostic score on survival after curative thoracoscopic esophagectomy for esophageal cancer.
abstract: BACKGROUND
  Despite recent improvements in early detection, progress in surgical techniques, and development of chemoradiation therapies, prognosis of esophageal cancer remains poor. The aim of the present study was to assess whether Glasgow Prognostic Score (GPS), an inflammation-based prognostic score, has prognostic value independent of conventional clinicopathological criteria in patients undergoing curative resection for esophageal cancer, even in elderly patients.
  
  
  METHODS
  We retrospectively reviewed the database of 141 consecutive patients with histologically verified esophageal squamous cell carcinoma who underwent potentially curative surgery in our institute, between January 2006 and December 2014. GPS and neutrophil lymphocyte ratio (NLR) were calculated.
  
  
  RESULTS
  On multivariate analysis, TNM stage (p < 0.0001) and GPS (p = 0.041) were independently associated with worse prognosis in overall patients with esophageal cancer. Multivariate analysis evaluated the prognostic factors in two different patient groups: patients younger than 70 years (non-elderly) and those aged 70 years or more (elderly). Multivariate analysis demonstrated that TNM stage (p = 0.0003) was an only independent risk factor for a worse prognosis among non-elderly group. Meanwhile, multivariate analysis demonstrated that TNM stage (p = 0.001) and GPS (p = 0.043) were the independent risk factor for a worse prognosis among elderly group.
  
  
  CONCLUSIONS
  The present study demonstrated that GPS is associated with prognosis and can be considered as an independent prognostic marker in patients who underwent esophagectomy. Moreover, the GPS has the advantage of being simple to measure, routinely available and well standardized. But the present study failed to confirm the NLR as a significant predictor of survival following resection for esophageal cancer.
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan. Electronic address: norinorihirahara@yahoo.co.jp.
authors.forename: N
authors.initials: N
authors.lastname: Hirahara
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsubara
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takai
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Fujii
authors.affiliation: Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Tajima
mesh_terms: D000367:Age Factors; D000368:Aged; D002097:C-Reactive Protein / Q000276:immunology*; D002294:Carcinoma, Squamous Cell / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007249:Inflammation; D007958:Leukocyte Count; D008197:Lymph Node Excision; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009504:Neutrophils / Q000276:immunology*; D011379:Prognosis; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D013906:Thoracoscopy
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein; D002784:Cholesterol
keywords: Esophageal cancer; Glasgow Prognostic Score; Neutrophil lymphocyte ratio; Prognosis