RESUMEN
@#Objective To evaluate the prognostic value of preoperative inflammatory indexes in patients with local-advanced esophageal squamous cell carcinoma. Methods We retrospectively analyzed the clinical and prognostic data of 150 local-advanced esophageal squamous cell carcinoma patients who were treated by esophagectomy in Guangyuan Central Hospital from July 2014 to July 2015. There were 128 males and 22 females with average age of 62.23±8.48 years. The optimal cutoff value was determined by receiver operation characteristics (ROC) curve analysis. Patients were grouped according to the optimal cutoff values (NLR=3.49, PLR=152.28, MLR=0.36). Log-rank test, and multivariate Cox logistic regression modelling were used to assess the simultaneous influences of prognostic factors for survival outcomes after esophagectomy. Results The patients with higher ratio (NLR>3.49, PLR>152.28, MLR>0.36) had significantly shorter median progression free survival (PFS) and lower postoperative recurrent rate than those of the patients with lower ratio. The stratified analyses found that thelymph node staging and postoperative recurrent rate were positively correlated with the higher ratio. However, the tumor differentiation was negatively correlated with it. In univariate analyses, patients with preoperative NLR>3.49, PLR>152.28 and MLR>0.36 had a poorer prognosis. Furthermore, in multivariate analyses we found MLR>0.36 was also significantly associated with a decreased postoperative recurrent rate (HR=12.945, 95%CI 2.31 to 72.548, P=0.00). Conclusions The preoperative NLR, PLR and MLR are useful prognostic markers in patients with stage ⅢA-ⅣA esophageal squamous cell carcinoma who conducted esophagectomy.
RESUMEN
We report a patient with esophageal carcinoma accompanied by a double aortic arch. The preoperative computed tomography scan only detected the right aortic arch, but we found the double aortic arch during the operation. The patient underwent an esophagectomy through a left thoracotomy. Preoperative three-dimensional reconstruction of computed tomography images should be conducted to completely understand the anomalies of the great vessels.