Cumulative scores based onplasma D-dimer andserum albumin levels predict survival inesophageal squamous cell carcinoma patients treated withtransthoracic esophagectomy
- Author:
DeQingLiu
1
;
FangFangLi
;
WeiHuaJia
Author Information
1. State Key Laboratory of Oncology in South China
- Keywords:
DA score;
Esophageal squamous cell carcinoma;
Survival;
Prognostic factors;
Transthoracic esophagectomy
- From:Chinese Journal of Cancer
2016;35(3):121-129
- CountryChina
- Language:Chinese
-
Abstract:
Background:Recently, studies have shown that plasma D?dimer and serum albumin are prognostic markers for esophageal cancer. The purpose of this study was to evaluate a novel prognostic scoring system—DA score (combi?nation of preoperative plasma D?dimer and serum albumin levels)—and analyze the association between survival of patients with esophageal squamous cell carcinoma (ESCC) and their Glasgow prognostic score. Methods:In this retrospective study, preoperative biochemical markers and clinicopathologic factors in 260 ESCC patients treated with transthoracic esophagectomy were reviewed. According to receiver operating characteristic analysis, the cutoff values of D?dimer and albumin were deifned as 0.5μg/mL and 43.8g/L, respectively. Patients with high D?dimer levels (≥0.5μg/mL) and low albumin levels (<43.8g/L) were assigned a score of 2, those with only one of the two abnormalities were assigned a score of 1, and those with neither of the two abnormalities were assigned a score of 0. Results:ESCC patients with a DA score of 0, 1, and 2 numbered 55, 116, and 89, respectively. Survival analysis showed that patients with a DA score of 2 had lower overall survival (OS) rates than those with DA scores of 1 and 0 (37.1% vs. 52.6% and 76.4%,P<0.001); similar ifndings were observed for disease?free survival (DFS) rates (32.6% vs. 44.8% and 67.3%,P<0.001). In addition, the predictive value of the DA score was also signiifcant in patients with stages I–IIA and stages IIB–IV ESCC. Multivariate Cox regression analyses indicated that hazard ratios (HRs) for predicting OS of patients with DA scores 1 and 2 were 2.25 (P=0.010) and 3.14 (P<0.001), respectively, compared with those with a DA score of 0, and HRs for predicting DFS of patients with DA scores of 1 and 2 were 1.86 (P=0.023) and 2.68 (P<0.001), respectively, compared with those with a DA scores of 0. Conclusions:Our study suggests that preoperative DA scores are notably associated with postoperative survival of ESCC patients.
