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International Journal of Clinical Oncology

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Open Access 01-12-2017 | Original Article

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)

Authors: Tatsuya Okuno, Masashi Wakabayashi, Ken Kato, Masayuki Shinoda, Hiroshi Katayama, Hiroyasu Igaki, Yasuhiro Tsubosa, Takashi Kojima, Hiroshi Okabe, Yusuke Kimura, Tatsuyuki Kawano, Shinichi Kosugi, Yasushi Toh, Hoichi Kato, Kenichi Nakamura, Haruhiko Fukuda, Satoshi Ishikura, Nobutoshi Ando, Yuko Kitagawa, Japan Esophageal Oncology Group/Japan Clinical Oncology Group

Published in: International Journal of Clinical Oncology | Issue 6/2017

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

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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)
Authors: Tatsuya Okuno
Masashi Wakabayashi
Ken Kato
Masayuki Shinoda
Hiroshi Katayama
Hiroyasu Igaki
Yasuhiro Tsubosa
Takashi Kojima
Hiroshi Okabe
Yusuke Kimura
Tatsuyuki Kawano
Shinichi Kosugi
Yasushi Toh
Hoichi Kato
Kenichi Nakamura
Haruhiko Fukuda
Satoshi Ishikura
Nobutoshi Ando
Yuko Kitagawa
Japan Esophageal Oncology Group/Japan Clinical Oncology Group
Publication date: 01-12-2017
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 6/2017
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-017-1154-6

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Abstract

Background

Methods

Results

Conclusions

Clinical Trial Information

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