Prognostic significance of fibrinogen concentration combined with neutrophil-to-lymphocyte ratio in esophageal squamous cell carcinoma patients receiving neoadjuvant therapy
Feng Zhuo,Luo Hui,Sun Yanan,Liu Xiao, Li Xue,Cui Yingying,Wang Chenyu,Zheng Xiaoli,Wang Hao,Ye Ke,Fan Chengcheng, Ge Hong
Department of Radiation Oncology,Affiliated Tumor Hospital of Zhengzhou University,Zhengzhou 450008,China
Abstract：Objective To evaluate the prognostic value of a novel prediction model based on fibrinogen concentration in combination with neutrophil-to-lymphocyte ratio (F-NLR score) in patients with esophageal squamous cell carcinoma (ESCC) receiving neoadjuvant therapy and investigate their relationship with pathologic complete response (pCR). Methods Clinical data of 218 eligible ESCC patients treated with neoadjuvant therapy in the Affiliated Cancer Hospital of Zhengzhou University between 2012 and 2015 were retrospectively analyzed. The cut-off values for fibrinogen and neutrophil-to-lymphocyte ratio (NLR) were defined by the receiver operating characteristic (ROC) curve. The effects of different F-NLR scores on survival and pCR were evaluated. The survival rate was analyzed using the Kaplan-Meier method. The relationship among fibrinogen, NLR and pCR was analyzed by using Wilcoxon rank sum test. Results The 3-year overall survival (OS) rates with F-NLR scores of 0,1 and 2 were 72.1%,66.5% and 50.2%(P=0.010), respectively. The corresponding 3-year disease-free survival (DFS) rates were 64.1%, 60.2% and 45.4%(P=0.012), respectively. The clinical prognosis of patients with an F-NLR score of 2 was significantly worse compared with those of their counterparts with an F-NLR score of 0-1(P=0.003). Multivariate analysis demonstrated that the F-NLR score (P=0.004) and TNM stage (P=0.000) were the independent prognostic factors. Conclusions The F-NLR score can be used as an independent prognostic factor for ESCC patients treated with neoadjuvant therapy, which is promising supplement to current TNM staging system, thereby facilitating more accurate risk stratification analysis and achieving individualized multidisciplinary treatment for ESCC patients.
Feng Zhuo,Luo Hui,Sun Yanan et al. Prognostic significance of fibrinogen concentration combined with neutrophil-to-lymphocyte ratio in esophageal squamous cell carcinoma patients receiving neoadjuvant therapy[J]. Chinese Journal of Radiation Oncology, 2019, 28(3): 188-192.
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2019, Vol. 28 
