Association between the time of neutrophils to the lowest and prognosis of patients with esophageal squamous cell carcinoma treated with non-operative therapy
10.3760/cma.j.issn.0253-3766.2019.02.009
- VernacularTitle: 中性粒细胞减少至最低值的时间与非手术治疗食管鳞癌患者预后的关系
- Author:
Shuang LIU
1
;
Liping HUANG
1
;
Zheng LIN
1
;
Yanfang LIU
1
;
Zerong ZHENG
1
;
Xiane PENG
1
;
Weilin CHEN
2
;
Zhijian HU
1
Author Information
1. School of Public Health, Fujian Medical University, Fuzhou 350100, China
2. Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China
- Publication Type:Clinical Trail
- Keywords:
Esophageal neoplasms;
Squamous cel1 carcinoma;
Non-operative treatment;
Neutropenia;
Prognosis
- From:
Chinese Journal of Oncology
2019;41(2):124-128
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between the time of neutrophils to the lowest and prognosis of patients with esophageal squamous cell carcinoma (ESCC) treated with non-operative therapy.
Methods:The clinical data of 325 non-operative treated ESCC patients were collected in this study. The X-title software was applied to establish optimal threshold of neutrophil reduction to the lowest value. According to the optimal threshold, the patients were divided into early group (115 cases) and late group (210 cases). The clinical features and survival time of the two groups were compared, and the factors of prognosis were analyzed by Cox regression model with univariate and multivariate analysis.
Results:The X-title software demonstrated the optimal cutoff values for the time of neutrophils to the lowest was 39 days. The median overall survival time was 21.0 months in the early group which was significantly higher than that in the late group (16.0 months). Multivariate Cox regression analysis showed that the treatment methods and the time of neutrophils to the lowest were independent factors for overall survival of patients with ESCC treated by non-surgical therapy. Compared with radiotherapy alone, concurrent chemoradiation could benefit the survival (HR=0.64, P=0.026). The prognosis of patients in the late group of neutrophils to the lowest (HR=1.38, P=0.038) was poor compared with the early group. Furthermore, stratified by treatment methods, the overall survival of two groups showed statistically significant difference only in patients received concurrent chemoradiation. The mortality risk in the late group was higher than that in the early group (HR=3.53, P=0.010).
Conclusion:The time of neutrophils to the lowest is an independent prognosis factor for non-operative treated ESCC patients. The prognosis of patients in the early group is better than that in the late group.
