Skip to main content

Clinical significance of Osaka prognostic score based on nutritional and inflammatory status in patients with esophageal squamous cell carcinoma

Abstract

Background

It has been reported that Osaka prognostic score (OPS), based on C-reactive protein (CRP), total lymphocyte counts (TLC) and albumin (ALB), was relevant to prognosis in colorectal cancer. However, the role of OPS regarding prognosis in patients with esophageal squamous cell carcinoma (ESCC) has not been reported. The current study aimed to explore the clinical outcome of OPS and establish and validate a nomogram for survival prediction in ESCC after radical resection.

Methods

This retrospective study included 395 consecutive ESCC patients with radical resection. Then patients were randomly divided into two cohorts: training cohort (276) and validation cohort (119). The OPS, based on TLC, CRP and ALB, was constructed to verify the prognostic value by Kaplan-Meier curves and Cox analyses. A nomogram model for prognosis prediction of cancer-specific survival (CSS) was developed and validated in two cohorts.

Results

Kaplan-Meier curves regarding the 5-year CSS for the groups of OPS 0, 1, 2 and 3 were 55.3, 30.6, 17.3 and 6.7% (P < 0.001) in the training cohort and 52.6, 33.3, 15.8 and 9.1% (P < 0.001) in the validation cohort, respectively. Then the OPS score in multivariate Cox analysis was confirmed to be a useful independent score. Finally, a predictive OPS-based nomogram was developed and validated with a C-index of 0.68 in the training cohort and 0.67 in the validation cohort, respectively. All above results indicated that the OPS-based nomogram can accurately and effectively predict survival in ESCC after radical resection.

Conclusion

The OPS serves as a novel, convenient and effective predictor in ESCC after radical resection. The OPS-based nomogram has potential independent prognostic value, which can accurately and effectively predict individual CSS in ESCC after radical resection.

Peer Review reports

Introduction

Global cancer statistics 2018 revealed that esophageal cancer (EC) is one of the most common cancers worldwide with a total of 0.57 million new cases diagnosed and 0.51 million cases died from cancer [1]. Esophageal squamous cell carcinoma (ESCC) accounts for the majority of patients with EC, particularly in the high-incidence regions of China [2]. Despite advances in diagnosis and treatment in recent years, the survival prognosis for ESCC remains not satisfactory, mainly because the majority patients are diagnosed at advanced stages and lose the probability of curative resection [2, 3]. Therefore, the late diagnosis and poor prognosis of ESCC highlights the need to refine more sensitive and effective prediction methods, which are essential prior to treatment.

A growing number of studies revealed that cancer progression and prognosis is associated with nutritional and inflammatory status [4, 5]. Therefore, various inflammatory and/or nutritional indicators have been applied either alone or in combination to cancers in recent years. Serum C-reactive protein (CRP) and albumin (ALB) were the most widely recognized indicators to predict prognosis in a variety of cancers, including ESCC [6, 7]. The score system of Glasgow prognostic score (GPS) based on ALB and CRP was also confirmed as one of the most widely recognized scores for predicting clinical outcomes in a variety of cancers [8,9,10]. Moreover, a series of other indexes about inflammation and/or nutrition, such as prognostic nutritional index (PNI), systemic immune-inflammation index (SII) and systemic inflammation score (SIS), have also been confirmed to be associated with tumor prognosis [11,12,13,14].

Recently, a novel prognostic score based on the inflammatory and nutritional predictors, named Osaka Prognostic Score (OPS), was proposed for the first time to predict the prognosis in colorectal cancer (CRC) after radical resection [15]. Compared with other prognostic scores, the results demonstrated that the OPS, based on serum CRP, ALB and total lymphocyte count (TLC), had a reliable ability to predict prognosis in 511 CRC patients with radical resection. However, the application of OPS needs to be confirmed in other cancers. To date, moreover, there have been no reports regarding OPS in ESCC. Therefore, we initially explored the significance of OPS in patients with ESCC after radical resection for predicting cancer-specific survival (CSS). Finally, a nomogram based on OPS was also constructed and validated to predict individual survival for patients in ESCC after radical resection.

Materials and methods

Ethical statement

This study was approved by the ethics committee of Zhejiang Cancer Hospital (IRB.2021–6) and was performed in accordance with the Declaration of Helsinki. All retrospective data including in this study was anonymous, therefore, informed consent was waived by the ethics committee of Zhejiang Cancer Hospital.

Study population

Between 2012 and 2013, a total of 612 consecutive patients with EC with surgery in our department were retrospectively collected and analyzed. Patients who did not undergo radical resection and/or had any missing clinical or laboratory information were excluded from the study. The detail inclusion and exclusion criteria were shown in Fig. 1. Finally, the clinical records of the remaining 395 patients, who underwent above radical resection for ESCC, were retrospectively reviewed. All patients were then randomly assigned to a training cohort (n = 276) or validation cohort (n = 119) at a ratio of 7:3.

Fig. 1
figure 1

The flow diagram of selection of eligible patients. According to the inclusion and exclusion criteria, a total of 395 patients were randomly divided into either a training cohort (n = 276) or validation cohort (n = 119) at a ratio of 7:3 for further analysis

Treatment and follow-up

All patients underwent radical resection in the current study. The radical resection included the Ivor Lewis or McKeown procedure with two-field lymphadenectomy [16, 17]. The 8th AJCC/UICC TNM staging system was carried out for the current study [18]. Postoperative adjuvant treatment was still uncertain at that time. NCCN guidelines only recommend regular follow-up for those patients after radical resection. Thus, not all ESCC patients in China have received postoperative adjuvant therapy, which is mainly performed according to the postoperative pathological results as well as the physical and financial status of each patient [19, 20]. According to the previous studies, postoperative adjuvant treatments were carried out including cisplatin-based chemotherapy and/or radiotherapy, but not mandatory, for ESCC patients with positive lymph node metastasis and those with T3-T4 stage [21, 22]. Patients typically received a median of 4 cycles of postoperative chemotherapy consisting of cisplatin with fluorouracil or paclitaxel/docetaxel. Postoperative radiotherapy was consisted of three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT), which was initiated 4–8 weeks after radical resection with a median dosage of 50 Gy (1.8–2 Gy/fraction and 5 fractions per week) [19, 21, 22]. The patients were followed up with regular checks in our outpatient department. The routine examination items included physical examination, laboratory tests, tumor markers, thoracic CT scanning and esophageal barium. The last follow-up was completed in Dec. 2019.

Data collection and OPS definition

The clinical data including age, gender, tumor location, tumor length, differentiation, vessel invasion, perineural invasion and TNM stage and laboratory results including serum CRP, ALB, TLC, platelet (PLT), total neutrophil count (TNC) and total monocyte count (TMC) were retrospectively collected from our medical records. The above laboratory results were obtained within 1 week before surgery. The definitions of SIS, SII, PNI and GPS refer to the previous studies [11,12,13,14]. The OPS was calculated by the following three variables: CRP (≤ 10.0 mg/L: 0 point and > 10.0 mg/L: 1 point), ALB (≥ 3.5 g/dL: 0 point and < 3.5 g/dL: 1 point) and TLC (≥1600/uL: 0 point and < 1600/uL: 1 point). The OPS then was calculated as the summed score of 0 or 1, which divided into 4 groups. The detailed calculations of OPS, GPS, SIS, PNI and SII were shown in Fig. 2.

Fig. 2
figure 2

Calculation of the inflammatory and/or nutritional scores. The OPS based on CRP, ALB and TLC calculated into 4 groups. The GPS based on CRP and ALB calculated into 3 groups. The SIS based on ALB and LMR calculated into 3 groups. The PNI based on ALB and TLC calculated into 2 groups. The SII based on PLT, TNC and TLC calculated into 2 groups

Statistical analysis

Medcalc 17.6 (MedCalc Software bvba, Ostend, Belgium), R software (version 3.6.1, Vienna, Austria) and SPSS 20.0 (SPSS Inc., Chicago, IL, USA) were used to perform all statistical analyses in the current study. The areas under the curve (AUC) between OPS and other variables (SIS, SII, PNI and GPS) were compared by receiver operating characteristic (ROC) curves. The Kaplan-Meier method was used to compare the CSS. Cox regression analyses were performed to confirm independent factors. A prognostic nomogram was build based on the results in multivariate analyses. Calibrations of for survival prediction were performed by comparing the two cohorts. Time-dependent ROC curves and decision curves were also performed to evaluate the discriminative ability and predictive accuracy. All statistical tests were two-side and a P value < 0.05 was considered to be statistically significant.

Results

Patient characteristics in two cohorts

The baseline characteristics between the two cohorts were shown in Table 1. The median follow-up time was 39 months (range 9–92 months) in the training cohort and 42 months (range 7–90 months) in the validation cohort, respectively. Based on the criteria of the 8th edition AJCC TNM staging system, there were 79 (28.6%), 94 (34.1%) and 103 (37.3%) cases in stage I, II, and III in the training cohort and 33 (27.7%), 46 (38.7%) and 40 (33.6%) cases in the validation cohort, respectively. There were more male patients in the validation cohort than those in the training cohort (79.0% vs. 68.1%, P = 0.028). Otherwise, there was no significance difference between the two groups.

Table 1 Baseline characteristics of ESCC patients in the training and validation sets

Patient characteristics grouped by OPS

The results in the current study demonstrated that OPS was significantly associated with various baseline variables, such as TNM stage, vessel and perineural invasion, tumor length, differentiation, GPS, SIS, PNI and SII. The detailed baseline characteristics grouped by OPS was shown in Table 2.

Table 2 Comparison of baseline characteristics of ESCC patients based on OPS in training set

AUC comparisons between OPS and other variables

The AUC values comparisons according to the ROC curves between OPS and other variables (GPS, SIS, PNI and SII) were shown in Fig. 3. The AUC value regarding OPS was 0.683, indicated that OPS had the largest AUC compared with GPS (P = 0.0138, AUC = 0.627), SIS (P = 0.0426, AUC = 0.605), PNI (P = 0.1088, AUC = 0.631) and SII (P = 0.1665, AUC = 0.623). These results indicated that higher predictive ability of OPS on prognosis than other indicators.

Fig. 3
figure 3

AUC comparisons between OPS and other variables. The results indicated that OPS (AUC = 0.683) had the largest AUC compared with GPS (AUC = 0.627, P = 0.0138), SIS (AUC = 0.605, P = 0.0426), PNI (AUC = 0.631, P = 0.1088) and SII (AUC = 0.623, P = 0.1665). The results indicated that higher predictive ability of OPS than other indicators

CSS analyses and univariate and multivariate analyses

The 5-year CSS for the groups of OPS 0, 1, 2 and 3 were 55.3, 30.6, 17.3 and 6.7% in training cohort and 52.6, 33.3, 15.8 and 9.1% in validation cohort, respectively (P < 0.001, Fig. 4). The result revealed that OPS confirmed as an independent score associated with CSS according to the multivariate analysis (Table 3).

Fig. 4
figure 4

CSS analyses grouped by OPS. Kaplan-Meier curves revealed that 5-year CSS for groups of OPS 0, 1, 2 and 3 were 55.3, 30.6, 17.3 and 6.7% in training cohort (P < 0.001, A) and 52.6, 33.3, 15.8 and 9.1% in validation cohort (P < 0.001, B), respectively

Table 3 Univariate and multivariate Cox analyses of CSS in training set

Development and validation of the nomogram

Three variables according to the multivariate analyses (TNM, OPS and SII) were recruited to build a nomogram to predict individual survival (Fig. 5). The C-index was 0.68 in the training cohort and 0.67 in the validation cohort, respectively. An acceptable agreement between these two cohorts regarding the individual 5-year CSS prediction based on the calibration curves (Fig. 6A-B). The OPS-based nomogram had higher overall net benefits than TNM stages based on the time-dependent ROC analyses (Fig. 6C-D) and decision curve analyses (Fig. 6E-F). These results confirmed that the OPS-based nomogram can accurately and effectively predict survival in ESCC after radical resection.

Fig. 5
figure 5

Nomogram established based on OPS. Nomogram based on OPS for predicting 1-, 3- and 5-year CSS in ESCC after radical resection

Fig. 6
figure 6

Nomogram validated. Calibration curves for 5-year survival prediction presented an acceptable agreement between two cohorts (A-B). Time-dependent ROC curve analyses revealed survival prediction was significant higher in nomogram than TNM stage (C-D). Decision curve analyses revealed nomogram model had higher overall net benefits than TNM stage (E-F)

Discussion

To date, it is a dilemma to identify patients with ESCC who have aggressive behavior that leads to poor prognosis after surgical resection. Therefore, it is of great significance to explore more novel preoperative prognostic scores for postoperative prognosis in ESCC. The present study confirmed an integrative prognostic score of OPS, based on CRP, ALB and TLC, to predict clinical outcomes and prognosis in ESCC patients after radical resection. Compared with other indicators (GPS, SIS, PNI and SII), OPS had the largest AUC on the basis of ROC curves, which indicated that OPS had higher predictive ability on prognosis than other indicators. Then, OPS confirmed as a useful independent prognostic score. Moreover, a nomogram based on OPS was built and validated in the training and validation cohort, which can accurately and effectively predict prognosis in ESCC after radical resection.

Tumor prognosis is associated with inflammation and nutrition. CRP and ALB were the most widely recognized prognostic indicators in various cancers, including ESCC [6, 7]. GPS, based on CRP and ALB has been widely adopted as a systemic inflammatory and nutritional index, which indicated as a prognostic score not only for postoperative survival in ESCC but also for survival in various cancers [8,9,10]. In the current study, OPS, based on CRP, ALB and TLC, was performed to explore the clinical outcome in ESCC after radical resection. The results revealed that OPS had the higher abilities to predict prognosis than GPS (AUC = 0.683: 0.627, P = 0.0138) and confirmed as an independent score. Moreover, OPS in the present study also had the highest abilities to predict prognosis in ESCC compared with the other common indicators of SIS, PNI and SII in ROC analyses or Cox analyses.

The nutritional and/or inflammatory status may be influenced by a variety of non-cancer related conditions, which may lead to biased results. Therefore, more and more researchers are using these indicators in combination to reduce the potential bias and improve the prognostic value. Inflammation causes changes in tumor microenvironment and promotes proliferation, invasion and metastasis of cancer cells [23, 24]. Moreover, cancer itself may accelerate inflammation due to increased catabolism and malnutrition [25, 26]. There were two variables (CRP and ALB) in GPS and three variables (CRP, ALB and TLC) in OPS. CRP can induce a variety of inflammatory cytokines associated with cancers, such as interleukin-6 [27]. ALB, as a common marker regarding nutritional status, can activate a variety of cytokines, such as interleukin-1 and tumor necrosis factor-α [28]. When combined, GPS can effectively reflect potential inflammatory and nutritional status in tumor microenvironment. In addition, TLC plays an important role in the process of anti-tumor response, regulating angiogenesis, proliferation, apoptosis, and metastasis [29]. Therefore, the combination of additional TLC indicator resulted in a better stratification of OPS in prognosis than GPS in the current study and previous published study [15].

The present study explored an integrative prognostic score of OPS (based on CRP, ALB and TLC) to predict clinical outcomes and prognosis in ESCC after radical resection. Recently, a series of studies have revealed that nomogram is a better method to predict prognosis in various cancers [30, 31]. In the current study, our nomogram based on OPS containing three variables (OPS, TNM and SII) showed a better discrimination than the TNM staging system. The simply and easily obtained variables in nomogram, improves the application in clinical practice, allowing oncologists to use these nomogram to predict individual survival prediction in daily work. However, the prognostic value of OPS should be confirmed in more and more other cancers.

There are some limitations in the current study. First, this was a retrospective study. Second, this was a single-center study. Third, although the strict inclusion and exclusion criteria were adopted, levels of these serum variables may be affected by other conditions, therefore, the applications of OPS should be regard with caution. Forth, in order to better understand the prognostic value of OPS in patients with ESCC, we used two cohorts to verify the results. Although the prognostic value was validated, there was still a lack of additional independent external validation cohort. Therefore, the results of OPS may be correlated to certain bias and inaccuracy. Fifth, the prognostic value of OPS should be validated and confirmed in other more cancers. Sixth, endoscopic surgery (ES) and/or minimally invasive surgery (MIS) have become standard surgical methods for patients with EC in recent years. Compared with traditional surgical techniques, ES or MIS has a variety of advantages, such as decreased postoperative complications, shorter hospital stay and rapid recovery and discharge [32, 33]. The nutritional and immunological status for patients with ES or MIS has a lesser influence on the occurrence of postoperative complications. Accordingly, we should realize that the significance of OPS is likely to be reduced by the development of ES or MIS. Although the limitations existed, our developed OPS-based nomogram can accurately and effectively predict survival in ESCC after radical resection.

Conclusion

The OPS is a novel, simple and effective index for prognosis in ESCC after radical resection. The nomogram based on OPS can accurately and effectively predict individual survival in ESCC after radical resection. The simply and easily obtained feature of OPS, improves the application in daily clinical practice. The OPS may allow for treatment stratification, thereby helping clinicians provide a more personalized approach to cancer treatment.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ESCC:

Esophageal squamous cell carcinoma

SD:

Standard deviation

CRP:

C-reactive protein

ALB:

Albumin

PLT:

Platelet

TNC:

Total neutrophil count

TLC:

Total lymphocyte count

TMC:

Total monocyte count

OPS:

Osaka prognostic score

GPS:

Glasgow prognostic score

SIS:

Systemic inflammation score

TNM:

Tumor node metastasis

PNI:

Prognostic nutritional index

SII:

Systemic immune-inflammation index

HR:

Hazard ratio

CI:

Confidence interval

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Article  Google Scholar 

  2. Lin Y, Totsuka Y, Shan B, Wang C, Wei W, Qiao Y, et al. Esophageal cancer in high-risk areas of China: research progress and challenges. Ann Epidemiol. 2017;27(3):215–21.

    Article  Google Scholar 

  3. Huang FL, Yu SJ. Esophageal cancer: risk factors, genetic association, and treatment. Asian J Surg. 2018;41(3):210–5.

    Article  Google Scholar 

  4. Bullock AF, Greenley SL, McKenzie GAG, Paton LW, Johnson MJ. Relationship between markers of malnutrition and clinical outcomes in older adults with cancer: systematic review, narrative synthesis and meta-analysis. Eur J Clin Nutr. 2020;74(11):1519–35.

    Article  Google Scholar 

  5. Michels N, van Aart C, Morisse J, Mullee A, Huybrechts I. Chronic inflammation towards cancer incidence: a systematic review and meta-analysis of epidemiological studies. Crit Rev Oncol Hematol. 2021;157:103177.

    Article  Google Scholar 

  6. Komura N, Mabuchi S, Shimura K, Kawano M, Matsumoto Y, Kimura T. Significance of pretreatment C-reactive protein, albumin, and C-reactive protein to albumin ratio in predicting poor prognosis in epithelial ovarian cancer patients. Nutr Cancer. 2021;73(8):1357–64.

    CAS  Article  Google Scholar 

  7. Suzuki T, Ishibashi Y, Tsujimoto H, Nomura S, Kouzu K, Itazaki Y, et al. A novel systemic inflammatory score combined with immunoinflammatory markers accurately reflects prognosis in patients with esophageal cancer. In Vivo. 2020;34(6):3705–11.

    CAS  Article  Google Scholar 

  8. Hirahara N, Matsubara T, Kaji S, Kawabata Y, Hyakudomi R, Yamamoto T, et al. Glasgow prognostic score is a better predictor of the long-term survival in patients with gastric cancer, compared to the modified Glasgow prognostic score or high-sensitivity modified Glasgow prognostic score. Oncotarget. 2020;11(45):4169–77.

    Article  Google Scholar 

  9. Kikuchi R, Takoi H, Tsuji T, Nagatomo Y, Tanaka A, Kinoshita H, et al. Glasgow prognostic score predicts chemotherapy-triggered acute exacerbation-interstitial lung disease in patients with non-small cell lung cancer. Thorac Cancer. 2021;12(5):667–75.

    CAS  Article  Google Scholar 

  10. McSorley ST, Lau HYN, McIntosh D, Forshaw MJ, McMillan DC, Crumley AB. Staging the tumor and staging the host: pretreatment combined neutrophil lymphocyte ratio and modified Glasgow prognostic score is associated with overall survival in patients with esophagogastric cancers undergoing treatment with curative intent. Ann Surg Oncol. 2021;28(2):722–31.

    Article  Google Scholar 

  11. Markus M, Abendroth A, Noureddine R, Paul A, Breitenbuecher S, Virchow I, et al. Combined systemic inflammation score (SIS) correlates with prognosis in patients with advanced pancreatic cancer receiving palliative chemotherapy. J Cancer Res Clin Oncol. 2021;147(2):579–91.

    CAS  Article  Google Scholar 

  12. Zhang W, Wang R, Ma W, Wu Y, Maskey N, Guo Y, et al. Systemic immune-inflammation index predicts prognosis of bladder cancer patients after radical cystectomy. Ann Transl Med. 2019;7(18):431.

    CAS  Article  Google Scholar 

  13. Okadome K, Baba Y, Yagi T, Kiyozumi Y, Ishimoto T, Iwatsuki M, et al. Prognostic nutritional index, tumor-infiltrating lymphocytes, and prognosis in patients with esophageal Cancer. Ann Surg. 2020;271(4):693–700.

    Article  Google Scholar 

  14. Han L, Song Q, Jia Y, Chen X, Wang C, Chen P, et al. The clinical significance of systemic inflammation score in esophageal squamous cell carcinoma. Tumour Biol. 2016;37(3):3081–90.

    CAS  Article  Google Scholar 

  15. Fujino S, Myoshi N, Saso K, Sasaki M, Ishikawa S, Takahashi Y, et al. The inflammation-nutrition score supports the prognostic prediction of the TNM stage for colorectal cancer patients after curative resection. Surg Today. 2020;50(2):163–70.

    CAS  Article  Google Scholar 

  16. Sabra MJ, Alwatari YA, Wolfe LG, Xu A, Kaplan BJ, Cassano AD, et al. Ivor Lewis vs Mckeown esophagectomy: analysis of operative outcomes from the ACS NSQIP database. Gen Thorac Cardiovasc Surg. 2020;68(4):370–9.

    CAS  Article  Google Scholar 

  17. Zhang T, Hou X, Li Y, Fu X, Liu L, Xu L, et al. Effectiveness and safety of minimally invasive Ivor Lewis and McKeown oesophagectomy in Chinese patients with stage IA-IIIB oesophageal squamous cell cancer: a multicentre, non-interventional and observational study. Interact Cardiovasc Thorac Surg. 2020;30(6):812–9.

    Article  Google Scholar 

  18. Rice TW, Ishwaran H, Hofstetter WL, Kelsen DP, Apperson-Hansen C, Blackstone EH, et al. Recommendations for pathologic staging (pTNM) of cancer of the esophagus and esophagogastric junction for the 8th edition AJCC/UICC staging manuals. Dis Esophagus. 2016;29(8):897–905.

    CAS  Article  Google Scholar 

  19. Xu Y, Yu X, Chen Q, Mao W. Neoadjuvant versus adjuvant treatment: which one is better for resectable esophageal squamous cell carcinoma? World J Surg Oncol. 2012;10:173.

    CAS  Article  Google Scholar 

  20. Zhu Y, Li M, Kong L, Yu J. Postoperative radiation in esophageal squamous cell carcinoma and target volume delineation. Onco Targets Ther. 2016;9:4187–96.

    Article  Google Scholar 

  21. Li J, Qiu R, Hu Y, Wang Y, Qi Z, He M, et al. Postoperative adjuvant therapy for patients with pN+ esophageal squamous cell carcinoma. Biomed Res Int. 2021;2021:8571438.

    PubMed  PubMed Central  Google Scholar 

  22. Li L, Zhao L, Lin B, Su H, Su M, Xie D, et al. Adjuvant therapeutic modalities following three-field lymph node dissection for stage II/III esophageal squamous cell carcinoma. J Cancer. 2017;8(11):2051–9.

    Article  Google Scholar 

  23. Deshmukh SK, Srivastava SK, Poosarla T, Dyess DL, Holliday NP, Singh AP, et al. Inflammation, immunosuppressive microenvironment and breast cancer: opportunities for cancer prevention and therapy. Ann Transl Med. 2019 Oct;7(20):593.

    CAS  Article  Google Scholar 

  24. Ferrari SM, Fallahi P, Galdiero MR, Ruffilli I, Elia G, Ragusa F, et al. Immune and inflammatory cells in thyroid Cancer microenvironment. Int J Mol Sci. 2019;20(18):4413.

    CAS  Article  Google Scholar 

  25. Daniele A, Divella R, Abbate I, Casamassima A, Garrisi VM, Savino E, et al. Assessment of nutritional and inflammatory status to determine the prevalence of malnutrition in patients undergoing surgery for colorectal carcinoma. Anticancer Res. 2017;37(3):1281–7.

    CAS  Article  Google Scholar 

  26. Unal D, Eroglu C, Ozsoy SD, Besirli A, Orhan O, Kaplan B. Effect on long-term survival of psychiatric disorder, inflammation, malnutrition, and radiotherapy-related toxicity in patients with locally advanced head and neck cancer. J BUON. 2015;20(3):886–93.

    PubMed  Google Scholar 

  27. Germano G, Allavena P, Mantovani A. Cytokines as a key component of cancer-related inflammation. Cytokine. 2008;43(3):374–9.

    CAS  Article  Google Scholar 

  28. Chojkier M. Inhibition of albumin synthesis in chronic diseases: molecular mechanisms. J Clin Gastroenterol. 2005;39(4):S143–6.

    CAS  Article  Google Scholar 

  29. Kim SH, Lee HW, Go SI, Lee SI, Lee GW. Clinical significance of the preoperative platelet count and platelet-to-lymphocyte ratio (PLT-PLR) in patients with surgically resected non-small cell lung cancer. Oncotarget. 2016;7(24):36198–206.

    Article  Google Scholar 

  30. Zeng X, Liu G, Pan Y, Li Y. Development and validation of immune inflammation-based index for predicting the clinical outcome in patients with nasopharyngeal carcinoma. J Cell Mol Med. 2020;24(15):8326–49.

    CAS  Article  Google Scholar 

  31. Wang Y, Sun K, Shen J, Li B, Kuang M, Cao Q, et al. Novel prognostic nomograms based on inflammation-related markers for patients with hepatocellular carcinoma underwent hepatectomy. Cancer Res Treat. 2019;51(4):1464–78.

    Article  Google Scholar 

  32. Naveed M, Kubiliun N. Endoscopic treatment of early-stage esophageal cancer. Curr Oncol Rep. 2018;20(9):71.

    Article  Google Scholar 

  33. Li Z, Liu C, Liu Y, Yao S, Xu B, Dong G. Comparisons between minimally invasive and open esophagectomy for esophageal cancer with cervical anastomosis: a retrospective study. J Cardiothorac Surg. 2020;15(1):128.

    Article  Google Scholar 

Download references

Acknowledgments

No further acknowledgments.

Funding

This study was supported by grants from Zhejiang Medical and Health Science and Technology Project (2018KY289 to LW1, 2018KY290 and 2019RC129 to JF). This study was also supported by Zhejiang TCM Science and Technology Project (2021ZB034 to JF).

Author information

Authors and Affiliations

Authors

Contributions

JF, XY and GL conceived and designed the study. JF and LW1 collected the clinical baseline characteristics and drafted the manuscript. LW2 and XY carried out the follow-up. FJF and LW1 performed the data analyses and statistical analyses. FJF and YX conceived the study, helped to draft and approve the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xun Yang or Guangyuan Lou.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the ethics committee of Zhejiang Cancer Hospital (IRB.2021–6) and was performed in accordance with the Declaration of Helsinki. All retrospective data including in this study was anonymous, therefore, informed consent was waived by the ethics committee of Zhejiang Cancer Hospital.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Feng, J., Wang, L., Wang, L. et al. Clinical significance of Osaka prognostic score based on nutritional and inflammatory status in patients with esophageal squamous cell carcinoma. BMC Cancer 22, 284 (2022). https://doi.org/10.1186/s12885-022-09406-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12885-022-09406-6

Keywords

  • Esophageal squamous cell carcinoma
  • Osaka prognostic score
  • Cancer-specific survival
  • C-reactive protein
  • Albumin
  • Total lymphocyte count