Frontiers in Nutrition (Aug 2022)
A Nutrition-Related Factor-Based Risk Stratification for Exploring the Clinical Benefits in the Treatment of Patients With Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Definitive Chemoradiotherapy: A Retrospective Cohort Study
- Yilin Yu,
- Yilin Yu,
- Yilin Yu,
- Yilin Yu,
- Haishan Wu,
- Haishan Wu,
- Haishan Wu,
- Jianjian Qiu,
- Jianjian Qiu,
- Jianjian Qiu,
- Dongmei Ke,
- Dongmei Ke,
- Dongmei Ke,
- Yahua Wu,
- Yahua Wu,
- Yahua Wu,
- Mingqiang Lin,
- Mingqiang Lin,
- Mingqiang Lin,
- Tianxiu Liu,
- Tianxiu Liu,
- Tianxiu Liu,
- Qunhao Zheng,
- Qunhao Zheng,
- Qunhao Zheng,
- Hongying Zheng,
- Hongying Zheng,
- Hongying Zheng,
- Jun Yang,
- Jun Yang,
- Jun Yang,
- Zhiping Wang,
- Zhiping Wang,
- Zhiping Wang,
- Hui Li,
- Hui Li,
- Hui Li,
- Lingyun Liu,
- Lingyun Liu,
- Lingyun Liu,
- Qiwei Yao,
- Qiwei Yao,
- Qiwei Yao,
- Jiancheng Li,
- Jiancheng Li,
- Jiancheng Li,
- Wenfang Cheng,
- Wenfang Cheng,
- Wenfang Cheng,
- Xiaohui Chen,
- Xiaohui Chen,
- Xiaohui Chen
Affiliations
- Yilin Yu
- Department of Thoracic Surgery, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Yilin Yu
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Yilin Yu
- The Graduate School, Fujian Medical University, Fuzhou, China
- Yilin Yu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Haishan Wu
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Haishan Wu
- The Graduate School, Fujian Medical University, Fuzhou, China
- Haishan Wu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Jianjian Qiu
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Jianjian Qiu
- The Graduate School, Fujian Medical University, Fuzhou, China
- Jianjian Qiu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Dongmei Ke
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Dongmei Ke
- The Graduate School, Fujian Medical University, Fuzhou, China
- Dongmei Ke
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Yahua Wu
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Yahua Wu
- The Graduate School, Fujian Medical University, Fuzhou, China
- Yahua Wu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Mingqiang Lin
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Mingqiang Lin
- The Graduate School, Fujian Medical University, Fuzhou, China
- Mingqiang Lin
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Tianxiu Liu
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Tianxiu Liu
- The Graduate School, Fujian Medical University, Fuzhou, China
- Tianxiu Liu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Qunhao Zheng
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Qunhao Zheng
- The Graduate School, Fujian Medical University, Fuzhou, China
- Qunhao Zheng
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Hongying Zheng
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Hongying Zheng
- The Graduate School, Fujian Medical University, Fuzhou, China
- Hongying Zheng
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Jun Yang
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Jun Yang
- The Graduate School, Fujian Medical University, Fuzhou, China
- Jun Yang
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Zhiping Wang
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Zhiping Wang
- The Graduate School, Fujian Medical University, Fuzhou, China
- Zhiping Wang
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Hui Li
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Hui Li
- The Graduate School, Fujian Medical University, Fuzhou, China
- Hui Li
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Lingyun Liu
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Lingyun Liu
- The Graduate School, Fujian Medical University, Fuzhou, China
- Lingyun Liu
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Qiwei Yao
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Qiwei Yao
- The Graduate School, Fujian Medical University, Fuzhou, China
- Qiwei Yao
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Jiancheng Li
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Jiancheng Li
- The Graduate School, Fujian Medical University, Fuzhou, China
- Jiancheng Li
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Wenfang Cheng
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Wenfang Cheng
- The Graduate School, Fujian Medical University, Fuzhou, China
- Wenfang Cheng
- Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Xiaohui Chen
- Department of Thoracic Surgery, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China
- Xiaohui Chen
- College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, China
- Xiaohui Chen
- The Graduate School, Fujian Medical University, Fuzhou, China
- DOI
- https://doi.org/10.3389/fnut.2022.896847
- Journal volume & issue
-
Vol. 9
Abstract
ObjectiveNo study has reported the risk stratification of BMI and PNI in patients with locally advanced esophageal squamous cell carcinoma (ESCC) undergoing definitive chemoradiotherapy (dCRT). This study aimed to construct a risk stratification to guide the treatment of ESCC following dCRT.MethodsA total of 1,068 patients with locally advanced ESCC who received dCRT were retrospectively analyzed. The impacts of clinicopathological factors on overall survival (OS) and progression-free survival (PFS) were analyzed. Besides, the novel prognostic indices of pre-therapeutic nutritional index (PTNI) and prognostic index (PI) were developed.ResultsThe median follow-up period of OS and PFS were 22.9 and 17.4 months, respectively. The high body mass index (BMI) group had better 5-year OS and PFS (36.4 and 34.0%) than the low BMI group (18.8 and 17.2%). The high prognostic nutritional index (PNI) group also had better 5-year OS and PFS (33.4 and 30.9%) than the low PNI group (17.5 and 17.2%). Multivariate Cox regression analysis showed that BMI and PNI were independent prognostic factors for OS and PFS. Based on nutritional indices, patients were categorized into the low-risk (PTNI = 1), medium-risk (PTNI = 2), and high-risk (PTNI = 3) groups with 5-year OS rates of 38.5, 18.9, 17.5%, respectively (p < 0.001) and 5-year PFS rates of 35.8, 17.6, 16.8%, respectively (p < 0.001). Besides, we also constructed a prognostic index (PI) for OS and PFS which was calculated based on statistically significant factors for predicting OS and PFS. The results revealed that the high-risk group had worse OS and PFS than the low-risk group (p < 0.001). Finally, RCS analysis demonstrated a non-linear relationship between the PNI, BMI, and survival for patients with ESCC. The death hazard of PNI and BMI sharply decreased to 41.8 and 19.7.ConclusionThe decreased pre-therapeutic BMI and PNI levels were associated with a worse survival outcome. BMI and PNI are readily available and can be used to stratify risk factors for locally advanced ESCC patients undergoing dCRT. The novel risk stratification may help to evaluate patients’ pre-therapeutic status and guide dCRT for locally advanced ESCC patients.
Keywords
- esophageal squamous cell carcinoma
- body mass index
- prognostic nutritional index
- nutritional indices
- risk stratification
- definitive chemoradiotherapy