The prognostic value of Tumor Volume Index in patients with esophageal cancer who had curative resection A single center experience.

AIM: We aim to evaluate the prognostic significance of tumor volume in esophageal cancer. METHODS: Patients who underwent curative resection due to esophageal cancer between the years 2015 and 2019 were included in the study. The Tumor Depth Parameter (TDP) was defined as mucosa and submucosa =1, muscularis propria =2, adventitia =3, and invasion into adjacent organs=4. The Tumor Volume Index (TVI) was defined as the major axis X the minor axis X TDP. Two groups were formed based on TVI: Group 1 (low TVI) and Group 2 (high TVI). In the groups; patients were compared in terms of demographic and clinical features, intraoperative and postoperative outcomes, characteristics of the tumor and average survival. RESULTS: The patients were divided into two groups based on the cut-off value of 4,000. Group 1 (low TVI) consisted of 16 patients and Group 2 (high TVI) consisted of 28 patients. Male sex ratio was higher in Group 2 (50% vs 85%, p:0.011) Tumor diameter was observed to be larger in Group 2 (3.06 vs 5.54, p:0.000). Adenocarcinoma histologic type was more common in Group 2 (25% vs 64.3%, p:0.012). Incidence of respiratory complications was higher in Group 2 (0% vs 35.7%, p:0.024),Survival time (months) was shorter in Group 2 (36 vs 11, p:0.005). TVI's being over 4000 (HR)(95%-Confidence Interval ((Cl) 0.057 (0.011-0.311),p:0.001) was an independent risk factor to determine the rate of survival. CONCLUSION: TVI can be used as a prognostic factor in patients with esophageal cancer who underwent surgical therapy. TVI is closely associated with tumor histology and postoperative outcomes. KEY WORDS: Esophageal cancer, Prognosis, Postoperative complication, Surgical manangment, Survey, Tumor volume.

Prognostic significance of the neutrophil to lymphocyte ratio in patients with curative resection of esophageal cancer. A single center experience.

AIM: In this study, we aimed to determine the clinical value and prognostic significance of the Neutrophil / Lymphocyte Ratio in patients undergoing curative surgery due to esophageal cancer. MATERIAL AND METHOD: Patients who underwent curative resection for esophageal cancer between 2015-2019 were included in the study. Two groups, Group1 (low NLR) and Group2 (high NLR), were created. Demographic and clinical features, intraoperative and postoperative results, tumor characteristics and mean survival were compared in the groups. RESULTS: A total of 48 patients participated in our study. Group 1 consisted of 18 patients and Group 2 consisted of 30 patients. Male sex was dominant in both groups (66.7% vs 73.3%, p. 0.431). Preoperative CEA was higher in Group 2 (3.97 vs 9.57, p. 0.032). Tumor diameter was larger in Group2 (3.33 vs 5.40 cm, p. 0.000). Adenocarcinoma was higher in Group 2 (33% vs 53.3%, p. 0.047), while squamous cell carcinoma was higher in Group 1 (66.7% vs 33.3%, p. 0.047). Lymph node positivity was higher in Group 2 (66.7% vs 93.3%, p. 0.024). The anastomosis leak was higher in Group 2 (0% vs 20%, p. 0.048). Postoperative hospital stay was longer in Group 2 (13.27 vs 23.9 days, p. 0.009). 90-day readmission was higher in Group1 (33.3% vs 3.3%, p. 0.008). Survival duration was shorter in Group 2 (29 vs 15 months, p. 0.005). CONCLUSION: This study revealed that preoperative high NLR was associated with poor survival, along with greater tumor diameter, increased lymph node metastasis rate, and increased anastomosis leakage in patients with esophageal cancer. These results suggest that modifying inflammatory responses and modulating the immune system may improve survival outcomes in patients with esophageal cancer. KEY WORDS: Esophagus cancer, Neutrophil/lymphocyte ratio, Preoperative neutrophil/lymphocyte ratio, Prognosis.