Utility of Blood Biomarkers as a Predictor of Pathological Lymph Node Metastasis in Clinical Stage T1N0 Esophageal Squamous Cell Carcinoma

Autor: Manato Ohsawa, Yoichi Hamai, Manabu Emi, Yuta Ibuki, Tomoaki Kurokawa, Toru Yoshikawa, Ryosuke Hirohata, Nao Kitasaki, Morihito Okada
Rok vydání: 2021
Předmět:
Popis: Background Accurate preoperative evaluation of lymph node (LN) metastasis is important for determining the treatment strategy for superficial esophageal cancer. There have been reports on the clinical significance of blood biomarkers, such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), as predictors of LN metastasis for different cancers. Methods Patients (n = 185) with cT1N0M0 esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy with R0 resection between April 2003 and August 2021 were enrolled. This study investigated the ability of the pretreatment NLR, PLR, and LMR to predict pathological LN metastasis. Results The optimal cut-off NLR, PLR, and LMR values to predict pathological LN metastasis were 2.1, 122, and 4.8, respectively. Univariate and multivariate analyses revealed that the primary tumor length, depth of invasion, and NLR were significant predictors of LN metastasis. Furthermore, similar to the five-year overall survival, the five-year relapse-free survival was significantly better in the low NLR group than in the high NLR group. Conclusions The NLR was the most useful predictor of pathological LN metastasis, which is difficult to predict by imaging for clinical stage T1N0M0 ESCC. Patients diagnosed with clinical stage I ESCC and with a high NLR require adequate LN dissection and may be good candidates for preoperative adjuvant therapy.
Databáze: OpenAIRE