PROGNOSTIC VALUE OF INFLAMMATORY AND IMMUNE INDICES IN NEOADJUVANT CONCURRENT CHEMORADIOTHERAPY FOR ESOPHAGEAL CANCER AT K HOSPITAL

Tóm tắt

Objectives: To evaluate the prognostic value of inflammatory–immune indices in patients with esophageal cancer treated with concurrent neoadjuvant chemoradiotherapy at K Hospital. Subjects and Methods: This retrospective longitudinal study included 57 patients with middle-to-lower thoracic esophageal cancer, histologically confirmed squamous cell carcinoma, stage II–III according to the 8th edition of the AJCC staging system, who were treated with concurrent neoadjuvant chemoradiotherapy at K Hospital from January 2018 to December 2024. Clinical characteristics, paraclinical findings, treatment-related variables, and the NLR(Neutrophil/Lymphocyte), PLR(Platelet/Lymphocyte), and SII indices were collected. Optimal cut-off values were determined using time-dependent ROC curves based on mortality endpoints and the Youden index. Overall survival was analyzed using the Kaplan–Meier method, log-rank test, ROC analysis, and Cox regression. Results: The median overall survival was 57 months; 3-year and 5-year overall survival rates were 73.3% and 41.9%, respectively. The optimal cut-off values for NLR, PLR, and SII were 5.3, 174.3, and 979.3. Patients with low SII had longer median survival than those with high SII (60 vs. 36 months; p=0.001). SII predicted 3-year overall survival with an AUC of 0.669 (p=0.035). In multivariable analysis, age >=60 years and nodal positivity were independent adverse prognostic factors, whereas low SII was an independent favorable prognostic factor (HR=0.131; 95% CI: 0.024-0.701; p=0.018). Conclusions: Post-nCRT preoperative SII is a simple and clinically applicable index with prognostic value for overall survival in patients with locally advanced esophageal squamous cell carcinoma treated with neoadjuvant concurrent chemoradiotherapy.