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Journal of International Oncology ›› 2022, Vol. 49 ›› Issue (2): 89-94.doi: 10.3760/cma.j.cn371439-20210526-00014

• Original Articles • Previous Articles     Next Articles

Influence of preoperative Naples prognostic score on prognosis of patients with thoracic esophageal squamous cell carcinoma

Guo Xinwei1, Zhang Han2, Ye Hongxun1, Liu Yangchen1, Ji Shengjun3, Zhou Shaobing1(), Zhou Juying4()   

  1. 1Department of Radiation Oncology, Affiliated Taixing People's Hospital of Yangzhou University, Taixing 225400, China
    2School of Mathematics, Nanjing Normal University Taizhou College, Taizhou 225300, China
    3Department of Radiation Oncology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215002, China
    4Department of Radiation Oncology, First Affiliated Hospital of Soochow University, Suzhou 215006, China
  • Received:2021-05-26 Revised:2021-12-25 Online:2022-02-08 Published:2022-03-11
  • Contact: Zhou Shaobing,Zhou Juying E-mail:zsb633@163.com;zhoujuyingsy@163.com
  • Supported by:
    Project of Suzhou Cancer Clinical Medical Center(Szzx201506)

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Abstract:

Objective To explore the impact of preoperative Naples prognostic score (NPS) on the survival prognosis of patients with thoracic esophageal squamous cell carcinoma (ESCC). Methods From December 2014 to December 2020, a total of 134 patients who underwent radical esophagectomy in Department of Thoracic Surgery, Affiliated Taixing People's Hospital of Yangzhou University were retrospectively analyzed. The NPS was calculated by the median values of preoperative serum albumin, total cholesterol, neutrophil to lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR), and then the enrolled patients were divided into NPS 0 group (20 cases), NPS 1 or 2 group (62 cases) and NPS 3 or 4 group (52 cases). Kaplan-Meier method was used to calculate survival rate and survival comparison was performed by log-rank test. The univa-riate and multivariate Cox models were used to analyze the relationship between NPS and survival prognosis. Results The 1-, 3- and 5-year progression free survival (PFS) rates were 95.0%, 70.0% and 60.0% in the NPS 0 group, 66.1%, 24.2% and 24.2% in the NPS 1 or 2 group, and 48.1%, 3.8% and 1.9% in the NPS 3 or 4 group respectively, with a statistically significant difference (χ2=31.27, P<0.001). In the NPS 0 group, the 1-, 3- and 5-year overall survival (OS) rates were 100.0%, 80.0% and 70.0% respectively. In the NPS 1 or 2 group, the 1-, 3- and 5-year OS rates were 96.8%, 36.7% and 32.3% respectively, while in the NPS 3 or 4 group, the 1-, 3- and 5-year OS rates were 90.4%, 32.7% and 5.8% respectively, and there was a statistically significant difference (χ 2=29.70, P<0.001). Univariate analysis found that sex, T stage, N stage, TNM stage and NPS were closely related to PFS and OS of patients with thoracic ESCC (all P<0.05). Furthermore, multivariate Cox regression analysis showed that T stage (HR=1.46, 95%CI: 1.07-2.00, P=0.019), N stage (HR=1.34, 95%CI: 1.02-1.76, P=0.037) and NPS (set NPS 0 group as the subvariable, NPS 1 or 2 group: HR=3.35, 95%CI: 1.58-7.11, P=0.002; NPS 3 or 4 group: HR=6.15, 95%CI: 2.89-13.11, P=0.001) were independent prognostic factors for PFS. Additionally, T stage (HR=1.67, 95%CI: 1.01-2.77, P=0.046), N stage (HR=1.44, 95%CI: 1.00-2.20, P=0.048) and NPS (set NPS 0 group as the subvariable, NPS 1 or 2 group: HR=3.10, 95%CI: 1.31-7.32, P=0.010; NPS 3 or 4 group: HR=5.09, 95%CI: 2.14-12.11, P=0.001) were independent prognostic factors for OS. Conclusion Preoperative NPS plays an important role in predicting the survival prognosis of patients with thoracic ESCC.

Key words: Esophageal neoplasms, Naples prognostic score, Prognosis