Kubo Yuto, Fujita Takeo, Sato Kazuma, Kajiyama Daisuke, Kubo Kentaro, Daiko Hiroyuki
Department of Esophageal Surgery, National Cancer Center East Hospital, Chiba, Japan.
Department of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Ann Surg Oncol. 2025 May 24. doi: 10.1245/s10434-025-17489-1.
Findings have shown that preoperative serum interleukin 6 (IL-6) concentrations are associated with treatment response and prognosis of patients with esophageal cancer. However, it has been unclear whether IL-6 concentrations after minimally invasive esophagectomy (MIE) have an impact on nutritional status and prognosis.
The cohort of this retrospective study comprised 336 patients who had undergone MIE with R0 for esophageal cancer from August 2020 to August 2022. The study investigated the relationship between postoperative serum IL-6 concentrations and outcomes.
The study created low-IL-6 (<60 pg/mL) and high-IL-6 (≥60 pg/mL) groups according to the upper-quartile postoperative serum IL-6 concentration 1 day after MIE. The high-IL-6 group had a significantly worse overall survival (OS) (2-year OS rate, 69.8% in high-IL-6 vs 80.6% in low-IL-6 group; p = 0.004). A high IL-6 was independently and significantly associated with poor OS (odds ratio, 1.548; 95% confidence interval, 1.027-2.335; p = 0.037). Several indices of malnutrition, including the modified Glasgow prognostic score (mGPS), 1 month after surgery, were significantly lower in the high-IL-6 group than in the low-IL-6 group. Multivariate analysis identified high serum IL-6 concentration 1 day after surgery as an independent risk factor for malnutrition.
The ultra-early postoperative serum IL-6 concentration has a negative impact on the nutrition and prognosis of patients who have undergone MIE for esophageal cancer. Decreasing serum IL-6 concentrations after esophagectomy may improve nutritional status and prognosis. It may be important for perioperative management and treatment strategies to target IL-6 after esophageal cancer surgery.
研究结果表明，术前血清白细胞介素6（IL-6）浓度与食管癌患者的治疗反应和预后相关。然而，微创食管切除术后（MIE）IL-6浓度是否会对营养状况和预后产生影响尚不清楚。
这项回顾性研究的队列包括2020年8月至2022年8月期间接受R0食管癌MIE手术的336例患者。该研究调查了术后血清IL-6浓度与预后之间的关系。
根据MIE术后1天血清IL-6浓度的上四分位数，该研究创建了低IL-6（<60 pg/mL）和高IL-6（≥60 pg/mL）组。高IL-6组的总生存期（OS）明显更差（2年OS率，高IL-6组为69.8%，低IL-6组为80.6%；p = 0.004）。高IL-6与不良OS独立且显著相关（比值比，1.548；95%置信区间，1.027 - 2.335；p = 0.037）。术后1个月，高IL-6组的包括改良格拉斯哥预后评分（mGPS）在内的多项营养不良指标明显低于低IL-6组。多因素分析确定术后1天高血清IL-6浓度是营养不良的独立危险因素。
食管癌MIE术后超早期血清IL-6浓度对患者的营养和预后有负面影响。降低食管切除术后血清IL-6浓度可能改善营养状况和预后。针对食管癌手术后的IL-6进行围手术期管理和治疗策略可能很重要。
