Postoperative inflammation is an independent prognostic factor in patients with thoracic esophageal squamous cell carcinoma

Abstract

Background: The aim of this study was to elucidate the impact of postoperative inflammatory response on prognosis in patients with stage I thoracic esophageal squamous cell carcinoma (ESCC). Materials and Methods: Seventy-five consecutive patients who underwent subtotal esophagectomy for clinical stage I thoracic ESCC were reviewed retrospectively. Maximum serum CRP level (CRPmax) and white blood celI count (WBCmax) were evaluated as postoperative inflammatory parameters. Prognostic factors were analyzed using Cox proportional hazards modeling. Results: Optimal cut-off values were 10.7 mg/dl for CRPmax and 19,700/mm3 for WBCmax. On univariate analyses, older age, worse performance status, higher WBCmax, and infectious complications were significantly associated with poorer overall survival. Multivariate analysis revealed WBCmax >19,700/mm3 to be an independent prognostic factor for poorer overall survival (hazard ratio=3.356; 95% confidence interval=1.221-9.220; p=0.019). Conclusion: A high WBCmax in the early postoperative phase, but not infectious complications, was an independent prognostic factor for poor overall survival in patients with clinical stage I thoracic ESCC.