Clinical implications of the preoperative lymphocyte C-reactive protein ratio in esophageal cancer patients

Surg Today. 2021 May;51(5):745-755. doi: 10.1007/s00595-020-02166-5. Epub 2020 Nov 1.

Abstract

Purpose: We recently revealed the preoperative lymphocyte C-reactive protein ratio (LCR) to be a new marker for predicting various outcomes in malignancies. The aim of our present study was to clarify the potential utility of the preoperative LCR for predicting the perioperative risk and oncological outcome in esophageal cancer patients.

Methods: We analyzed the preoperative LCR from 153 esophageal cancer patients to clarify its clinical relevance.

Results: The preoperative LCR was significantly decreased in a stage-dependent manner, and a decreased preoperative LCR was significantly associated with the occurrence of postoperative surgical site infection. Esophageal cancer patients with a low LCR showed a poor outcome in both the overall survival and disease-free survival compared with those who had a high LCR. Multivariate analyses showed that a decreased LCR was an independent prognostic factor for both a poor overall survival and disease-free survival. A decreased preoperative LCR was an independent predictive factor for postoperative surgical site infection and significantly correlated with nutritional and inflammatory indicators. In addition, the LCR was useful for identifying esophageal cancer patients likely to have a poor outcome among patients with and without neoadjuvant chemotherapy.

Conclusions: Assessing the preoperative LCR might help physicians identify populations at high risk for perioperative complication and oncological outcomes, and determine individualized perioperative therapeutic strategies.

Keywords: Chemoradiation; Esophageal cancer; Lymphocyte C-reactive protein ratio; Prognosis; Recurrence.

MeSH terms

  • Biomarkers / blood
  • C-Reactive Protein / metabolism*
  • Disease-Free Survival
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Female
  • Humans
  • Inflammation
  • Lymphocytes / metabolism
  • Male
  • Nutritional Status
  • Postoperative Complications / diagnosis
  • Predictive Value of Tests
  • Preoperative Period
  • Risk
  • Surgical Wound Infection / diagnosis
  • Treatment Outcome

Substances

  • Biomarkers
  • C-Reactive Protein