Impact of combined assessment of systemic inflammation and presarcopenia on survival for surgically resected esophageal cancer.

ABSTRACT

BACKGROUND: Systemic inflammation and low skeletal muscle volume (presarcopenia) have received increasing attention in many malignancies. However, their association and the combined effect on postoperative survival in esophageal cancer (EC) patients have been poorly studied. METHODS: Eighty-nine patients with EC who underwent surgery between 2006 and 2014 were included in this study. Neutrophil-to-lymphocyte ratio (NLR) ≥3.0 was categorized as having systemic inflammation. Presarcopenia was defined as a Skeletal muscle index (SMI) less than 52.4 cm2/m2 for men and less than 38.5 cm2/m2 for women. RESULTS: Multivariate analysis revealed that presarcopenia was an independent prognostic preoperative factor for overall survival (OS) (p = 0.004). Multivariate analysis for OS stratified by systemic inflammation revealed that presarcopenia with systemic inflammation (Hazard ratio(HR),20.70; 95% confidence interval (CI),1.34-318.90) was associated with nearly a seven-fold higher risk of death than those without systemic inflammation (HR, 2.94; 95%CI, 1.04-8.34). CONCLUSIONS: Systemic inflammation enhanced the effect of presarcopenia on the prognosis of EC patients. The combined assessment of those factors may have potential prognostic value for EC.