Esophageal stenosis and the Glasgow Prognostic Score as independent factors of poor prognosis for patients with locally advanced unresectable esophageal cancer treated with chemoradiotherapy (exploratory analysis of JCOG0303)

Japan Esophageal Oncology Group/Japan Clinical Oncology Group

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The aim of this study was to investigate the possible prognostic factors and predictive accuracy of the Glasgow Prognostic Score (GPS) for patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) treated with chemoradiotherapy. Methods: One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group. One hundred thirty-one patients with sufficient data were included in this analysis. A Cox regression model was used to analyze the prognostic factors of patients with unresectable LAESCC treated with PF-RT. The GPS was classified based on the baseline C-reactive protein (CRP) and serum albumin levels. Patients with CRP ≤1.0 mg/dL and albumin ≥3.5 g/dL were classified as GPS0. If only CRP was increased or only albumin was decreased, the patients were classified as GPS1, and the patients with CRP >1.0 mg/dL and albumin <3.5 g/dL were classified as GPS2. Results: The patients’ backgrounds were as follows: median age (range), 62 (37–75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31. Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7). Conclusions: Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients. Furthermore, GPS represents a prognostic factor for LAESCC patients treated with chemoradiotherapy. Clinical Trial Information: UMIN000000861.

Original languageEnglish
Pages (from-to)1042-1049
Number of pages8
JournalInternational Journal of Clinical Oncology
Volume22
Issue number6
DOIs
Publication statusPublished - 2017 Dec 1

Fingerprint

Esophageal Stenosis
Chemoradiotherapy
Esophageal Neoplasms
C-Reactive Protein
Albumins
Radiotherapy
Survival
Proportional Hazards Models
Serum Albumin
Fluorouracil
Cisplatin
Clinical Trials

Keywords

  • Chemoradiotherapy
  • Esophageal stenosis
  • Glasgow Prognostic Score
  • Prognostic factor
  • T4 esophageal cancer

ASJC Scopus subject areas

  • Surgery
  • Hematology
  • Oncology

Cite this

@article{65794ac9d9c546839b8d8fe7ff750ccf,
title = "Esophageal stenosis and the Glasgow Prognostic Score as independent factors of poor prognosis for patients with locally advanced unresectable esophageal cancer treated with chemoradiotherapy (exploratory analysis of JCOG0303)",
abstract = "Background: The aim of this study was to investigate the possible prognostic factors and predictive accuracy of the Glasgow Prognostic Score (GPS) for patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) treated with chemoradiotherapy. Methods: One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group. One hundred thirty-one patients with sufficient data were included in this analysis. A Cox regression model was used to analyze the prognostic factors of patients with unresectable LAESCC treated with PF-RT. The GPS was classified based on the baseline C-reactive protein (CRP) and serum albumin levels. Patients with CRP ≤1.0 mg/dL and albumin ≥3.5 g/dL were classified as GPS0. If only CRP was increased or only albumin was decreased, the patients were classified as GPS1, and the patients with CRP >1.0 mg/dL and albumin <3.5 g/dL were classified as GPS2. Results: The patients’ backgrounds were as follows: median age (range), 62 (37–75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31. Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7). Conclusions: Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients. Furthermore, GPS represents a prognostic factor for LAESCC patients treated with chemoradiotherapy. Clinical Trial Information: UMIN000000861.",
keywords = "Chemoradiotherapy, Esophageal stenosis, Glasgow Prognostic Score, Prognostic factor, T4 esophageal cancer",
author = "{Japan Esophageal Oncology Group/Japan Clinical Oncology Group} and Tatsuya Okuno and Masashi Wakabayashi and Ken Kato and Masayuki Shinoda and Hiroshi Katayama and Hiroyasu Igaki and Yasuhiro Tsubosa and Takashi Kojima and Hiroshi Okabe and Yusuke Kimura and Tatsuyuki Kawano and Shinichi Kosugi and Yasushi Toh and Hoichi Kato and Kenichi Nakamura and Haruhiko Fukuda and Satoshi Ishikura and Nobutoshi Ando and Yuukou Kitagawa",
year = "2017",
month = "12",
day = "1",
doi = "10.1007/s10147-017-1154-6",
language = "English",
volume = "22",
pages = "1042--1049",
journal = "International Journal of Clinical Oncology",
issn = "1341-9625",
publisher = "Springer Japan",
number = "6",

}

TY - JOUR

T1 - Esophageal stenosis and the Glasgow Prognostic Score as independent factors of poor prognosis for patients with locally advanced unresectable esophageal cancer treated with chemoradiotherapy (exploratory analysis of JCOG0303)

AU - Japan Esophageal Oncology Group/Japan Clinical Oncology Group

AU - Okuno, Tatsuya

AU - Wakabayashi, Masashi

AU - Kato, Ken

AU - Shinoda, Masayuki

AU - Katayama, Hiroshi

AU - Igaki, Hiroyasu

AU - Tsubosa, Yasuhiro

AU - Kojima, Takashi

AU - Okabe, Hiroshi

AU - Kimura, Yusuke

AU - Kawano, Tatsuyuki

AU - Kosugi, Shinichi

AU - Toh, Yasushi

AU - Kato, Hoichi

AU - Nakamura, Kenichi

AU - Fukuda, Haruhiko

AU - Ishikura, Satoshi

AU - Ando, Nobutoshi

AU - Kitagawa, Yuukou

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background: The aim of this study was to investigate the possible prognostic factors and predictive accuracy of the Glasgow Prognostic Score (GPS) for patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) treated with chemoradiotherapy. Methods: One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group. One hundred thirty-one patients with sufficient data were included in this analysis. A Cox regression model was used to analyze the prognostic factors of patients with unresectable LAESCC treated with PF-RT. The GPS was classified based on the baseline C-reactive protein (CRP) and serum albumin levels. Patients with CRP ≤1.0 mg/dL and albumin ≥3.5 g/dL were classified as GPS0. If only CRP was increased or only albumin was decreased, the patients were classified as GPS1, and the patients with CRP >1.0 mg/dL and albumin <3.5 g/dL were classified as GPS2. Results: The patients’ backgrounds were as follows: median age (range), 62 (37–75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31. Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7). Conclusions: Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients. Furthermore, GPS represents a prognostic factor for LAESCC patients treated with chemoradiotherapy. Clinical Trial Information: UMIN000000861.

AB - Background: The aim of this study was to investigate the possible prognostic factors and predictive accuracy of the Glasgow Prognostic Score (GPS) for patients with unresectable locally advanced esophageal squamous cell carcinoma (LAESCC) treated with chemoradiotherapy. Methods: One hundred forty-two patients were enrolled in JCOG0303 and assigned to the standard cisplatin and 5-fluorouracil (PF)-radiotherapy (RT) group or the low-dose PF-RT group. One hundred thirty-one patients with sufficient data were included in this analysis. A Cox regression model was used to analyze the prognostic factors of patients with unresectable LAESCC treated with PF-RT. The GPS was classified based on the baseline C-reactive protein (CRP) and serum albumin levels. Patients with CRP ≤1.0 mg/dL and albumin ≥3.5 g/dL were classified as GPS0. If only CRP was increased or only albumin was decreased, the patients were classified as GPS1, and the patients with CRP >1.0 mg/dL and albumin <3.5 g/dL were classified as GPS2. Results: The patients’ backgrounds were as follows: median age (range), 62 (37–75); male/female, 119/12; ECOG PS 0/1/2, 64/65/2; and clinical stage (UICC 5th) IIB/III/IVA/IVB, 3/75/22/31. Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7). Conclusions: Esophageal stenosis was identified as a candidate stratification factor for randomized trials of unresectable LAESCC patients. Furthermore, GPS represents a prognostic factor for LAESCC patients treated with chemoradiotherapy. Clinical Trial Information: UMIN000000861.

KW - Chemoradiotherapy

KW - Esophageal stenosis

KW - Glasgow Prognostic Score

KW - Prognostic factor

KW - T4 esophageal cancer

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U2 - 10.1007/s10147-017-1154-6

DO - 10.1007/s10147-017-1154-6

M3 - Article

VL - 22

SP - 1042

EP - 1049

JO - International Journal of Clinical Oncology

JF - International Journal of Clinical Oncology

SN - 1341-9625

IS - 6

ER -