%0 Journal Article
%T Systemic inflammation score as a predictor of death within one year after esophagectomy.
%A Sato S
%A Nakatani E
%A Hawke P
%A Nagai E
%A Taki Y
%A Nishida M
%A Watanabe M
%A Ohata K
%A Kanemoto H
%A Oba N
%J Esophagus
%V 21
%N 3
%D 2024 Jul 16
%M 38625663
%F 3.671
%R 10.1007/s10388-024-01059-7
%X BACKGROUND: After radical resection for esophageal cancer, death within 1 year of surgery can occur due both to recurrence and to other diseases, even after postoperative complications have been overcome. This study identified risk factors for early death within 1 year of esophagectomy for reasons other than death in hospital in patients undergoing esophagectomy for esophageal cancer or esophagogastric junction cancer.
METHODS: We reviewed 366 patients who underwent esophagectomy without adjuvant treatment between January 2009 and July 2022 for thoracic esophageal cancer or esophagogastric junction cancer. Patients who died within 1 year excluding in-hospital death were compared with those who did not. Multivariable logistic regression analysis was used to identify predictors of death within 1 year after surgery.
RESULTS: Death within 1 year occurred in 32 of 366 patients, 24 from primary disease and 8 from other diseases. Deaths within 1 year were significantly older than the other cases, had significantly lower % vital capacity (%VC), and occurred significantly more often in cases in advanced stages of disease. In a multivariable analysis, a systemic inflammation score (SIS) based on serum albumin level and lymphocyte-to-monocyte ratio was identified as an independent predictor of death within 1 year. As SIS increased, %VC decreased significantly, and CRP level and neutrophil-lymphocyte ratio increased significantly. There was no relationship between SIS and pN. Death within 1 year increased as SIS increased (p = 0.001 for trend).
CONCLUSIONS: SIS assessment undertaken before beginning esophageal cancer treatment is a useful predictor of death within 1 year of surgery.