Combining standard clinical blood values for improving survival prediction in patients with unresectable esophageal carcinoma: A retrospective study.

The prognosis for patients with esophageal squamous cell carcinoma (ESCC) is poor, with a 5-year survival rate of approximately 30%. There are significant differences in prognosis among patients, and some patients experience local recurrence and distant metastasis within 1 year after comprehensive treatment. Therefore, there is an urgent need for highly sensitive and specific biomarkers to assess the therapeutic risks and prognosis of patients with inoperable esophageal cancer. This study aimed to investigate the predictive value of the LabBM score in the survival of patients with inoperable ESCC. A single-center retrospective study was conducted, including 150 and 155 patients with unresectable ESCC who received concurrent chemoradiotherapy at our hospital between January 1, 2013, and June 30, 2018, and between July 1, 2018, and March 1, 2020, respectively, as the training and validation cohorts. Laboratory parameters, including lactate dehydrogenase, platelet count, C-reactive protein, and albumin, were collected 1 week prior to concurrent chemoradiotherapy. The LabBM score was calculated, and survival differences were analyzed across patients with different LabBM scores. Cox regression and Kaplan-Meier analyses were used to assess factors influencing progression-free survival (PFS) and overall survival (OS), aiming to clarify the prognostic value of the LabBM score for PFS and OS. In the training group, of the 150 patients enrolled, 123 were in the low LabBM group (0-1), 23 in the medium LabBM group (1.5-2), and 4 in the high LabBM group (2.5-3.5). The median survival was 33 months in the low LabBM group, 11 months in the medium LabBM group, and 6.5 months in the high LabBM group, with a significant difference in survival between the 3 groups (P = .000). Univariate Cox analysis showed that a higher LabBM score was associated with worse OS (P < .05). Multivariate Cox regression analysis revealed that a higher LabBM score (hazard ratios: 2.75, 95% CI: 1.08-7.03, P = .034) was an independent influencing factor for OS. In receiver operating characteristic analysis, the AUC area for OS and PFS predicted by the LabBM-based risk model was 0.92 (95% CI: 0.86-0.97, P = .00) and 0.956 (95% CI: 0.88-0.98, P = .000), respectively. The AUC for LabBM scores predicting OS and PFS were 0.63 (95% CI: 0.54-0.72, P = .011) and 0.61 (95% CI: 0.52-0.70, P = .039), respectively. The AUC area of the risk model was significantly higher than that of other single parameters. Subsequently, we re-enrolled 155 patients with inoperable esophageal cancer in different time periods for the above analysis, and the results were consistent with the experimental group. In inoperable ESCC patients, the LabBM score-based risk model is a novel and effective prognostic indicator.