Department of Hematologic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
Ann Surg Oncol. 2013 Mar;20(3):997-1004. doi: 10.1245/s10434-012-2658-y. Epub 2012 Sep 26.
Esophageal carcinosarcoma is a rare kind of malignancy, and how to identify the patients with poor prognosis is critical for improving treatment efficacy and survival outcome.
The clinical characteristics, pathologic features, treatments, and outcomes of esophageal carcinosarcoma were analyzed in 33 patients. Meanwhile, we hypothesized that elevated neutrophil to lymphocyte ratio (NLR) correlates with poor prognosis.
Most patients had polypoid tumors, and the carcinomatous elements were squamous in all patients except one with adenosquamous carcinoma. Eight patients had elevated NLR (≥5). The median follow-up time was 39.1 (range, 0.5-178.2) months. The median overall survival time (OS) was 43.5 months, and the 1-, 3-, and 5-year OS rates were 74, 57, and 48%, respectively. Tumor recurrence occurred in 15 patients, and the median relapse-free survival time (RFS) was 23.9 months, and the 2-year RFS rate was 50%. For patients who received curative resection, OS and RFS were significantly associated with preoperative NLR. In the multivariate Cox regression model, higher NLR was an independent prognostic factor (P value was 0.001 for both OS and RFS).
Our study identified the baseline NLR to be an independently prognostic factor for curatively resected esophageal carcinosarcoma.
食管肉瘤样癌是一种罕见的恶性肿瘤，如何识别预后不良的患者对于提高治疗效果和生存结局至关重要。
对 33 例食管肉瘤样癌患者的临床特征、病理特征、治疗方法和结局进行分析。同时，我们假设升高的中性粒细胞与淋巴细胞比值（NLR）与不良预后相关。
大多数患者为息肉样肿瘤，除 1 例腺鳞癌外，癌性成分均为鳞癌。8 例患者 NLR 升高（≥5）。中位随访时间为 39.1（范围，0.5-178.2）个月。中位总生存时间（OS）为 43.5 个月，1、3 和 5 年 OS 率分别为 74%、57%和 48%。15 例患者出现肿瘤复发，中位无复发生存时间（RFS）为 23.9 个月，2 年 RFS 率为 50%。对于接受根治性切除的患者，OS 和 RFS 与术前 NLR 显著相关。在多因素 Cox 回归模型中，较高的 NLR 是独立的预后因素（OS 和 RFS 的 P 值均为 0.001）。
本研究确定了基线 NLR 是可切除食管肉瘤样癌的独立预后因素。
